Diagnosis and management of nipple-areolar complex conditions in postmenopausal women: a retrospective study...

Nipple conditions in postmenopausal women are numerous and challenging to diagnose, requiring multidisciplinary collaboration. There are no large cohort studies detailing the epidemiology, symptoms, diagnoses, and disease trajectories for postmenopausal women with nipple complaints.

This single-institution retrospective study aimed to describe postmenopausal nipple complaints, associated symptoms, diagnoses, and involved medical care teams.

Medical charts of female patients over 49 years old with nipple-related diagnoses were reviewed. Data on demographics, symptoms, medical specialties, diagnostics, final diagnoses, and treatments were collected.

Physician-patient encounters (N = 296) for 174 unique patients ages 50 to 92 (average 70) were analyzed. Nipple inversion, pain, and dermatitis were the most common diagnoses. Primary care physicians (PCPs) cared for the majority of patients (73% first seen by PCP), with dermatologists, surgeons, and breast health specialists involved in over 25% of encounters. PCPs often referred patients to specialists when patients presented with a nipple rash with ulceration or an inverted nipple with discharge. Most patients (63%) received reassurance about benign or self-limited conditions, while others were treated with oral antibiotics, topical medications, or surgical management depending on the diagnosis.

This is a single institution retrospective chart review.

Most postmenopausal women with nipple complaints are diagnosed with inversion, pain, or dermatitis. This retrospective chart review highlights the need for multidisciplinary care of these patients, with the primary care provider serving as the frontline care provider for women with skin conditions of the nipple-areolar complex.