Are Inverted Nipples a Sign of Breast Cancer?

An inverted nipple that points inward or lies flat instead of pointing outward can be a sign of breast cancer. However, inverted nipples can be completely harmless, or other conditions can cause them. 

Typically, an inverted nipple associated with breast cancer happens when a tumor attacks a milk duct behind the nipple, causing the skin to pull inward, or when cancer cells affect the nipple itself. This symptom usually comes on suddenly and may accompany other breast changes.

This article discusses inverted nipples and treatment options due to breast cancer or other conditions.

What Is an Inverted Nipple?

An inverted nipple points inward toward your breast. It can also retract, meaning it lies flat against your areola, the circular area of pigmented skin around the nipple.  

Men and women can have or develop an inverted nipple on one or both breasts. It is typically something you are born with. About 2% of nipples are inverted.

Inverted nipples are classified as:

• Grade 1: The nipple can be pulled out with your fingers and stay outward for a couple of minutes but then return to their inverted position.
• Grade 2: The nipple can be pulled outward but will return inward when you let it go.
• Grade 3: The nipple is deeply inverted and can’t be pulled outward with your fingers. 

Is an Inverted Nipple a Symptom of Breast Cancer?

An inverted nipple can be a sign of breast cancer. This is especially true if the inversion comes on suddenly and it's a new occurrence.

If your healthcare provider suspects breast cancer, you may need to undergo certain tests, such as a mammogram, breast ultrasound, breast MRI (magnetic resonance imaging), or biopsy (removing a sample of tissue for analysis in a lab), to determine if the symptom is due to cancer or a benign condition.

Paget's Disease of the Breast

Nipple inversion is sometimes a symptom of a rare type of breast cancer called Paget's disease, which develops on the skin of the nipple and areola. People with Paget's disease usually also have ductal carcinoma in situ (DCIS) or invasive breast cancer inside the same breast.

Paget's disease is often mistaken for eczema and causes other symptoms, such as:

• Red, dry, crusty, or flaky skin around the nipple
• Itching and burning
• Nipple discharge that appears bloody or yellow

Breast Cancer That Invades the Milk Ducts

The nipple might reverse its direction and cause an inversion if breast cancer cells make their way into the milk ducts located behind the nipple.

Some other breast cancer symptoms to watch for that may accompany nipple inversion include:

• A lump or area of thickening in your breast
• Breast pain or tenderness
• Changes in the size or shape of your breast
• Skin changes in the breast, such as dimpling or redness

Treatments and Management of an Inverted Nipple

An inverted nipple that isn’t caused by a medical condition usually doesn’t require treatment. However, if healthcare providers discover that an inverted nipple is due to cancer, treatments may include:

• Surgery
• Chemotherapy
• Radiation therapy
• Hormone therapy
• Targeted therapy or immunotherapy

The treatments will depend on the type of breast cancer, how advanced it is, and other factors.

When to See Your Healthcare Provider

You should see your healthcare provider any time you notice breast changes, including an inverted nipple or any of the following:

• A breast lump
• Nipple discharge or any nipple changes
• Skin redness, swelling, flaking, or dimpling
• Itching or burning of the breast
• Pain in the breast
• Change in the shape or size of the breast

Summary

An inverted nipple can be a sign of breast cancer, but other conditions can cause it. If a nipple suddenly becomes inverted, it's more likely that cancer is the culprit. Other breast symptoms, such as a lump or skin changes, may be warning signs of breast cancer. If an inverted nipple is caused by breast cancer, you will need to treat the cancer as soon as possible. The earlier breast cancer is detected and treated, the better the outcome.

A Word From Verywell

You should see your healthcare provider if you notice changes in your breasts, including inverted nipples. While inverted nipples can be due to other conditions, your provider might need to rule out breast cancer. Even if you think it's nothing, you should get it checked out. It's always best to err on the side of caution.