Differential Diagnosis for Nipple Pain
- Single most likely diagnosis
- Breastfeeding issues (e.g., poor latching, nipple thrush): This is often the most common cause of nipple pain, especially in lactating women, due to the direct trauma or infection associated with breastfeeding.
- Other Likely diagnoses
- Mastitis: An infection of the breast tissue, which can cause pain, swelling, and redness, often associated with breastfeeding but can occur in non-lactating women as well.
- Nipple dermatitis or eczema: Skin conditions that can cause itching, redness, and pain in the nipple area.
- Breast cysts or fibroadenomas: Benign breast tumors that can cause localized pain, including nipple pain if they are close to the nipple.
- Hormonal changes: Fluctuations in hormone levels, such as those experienced during menstruation or menopause, can lead to breast and nipple tenderness.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Breast cancer: Although less common, breast cancer can present with nipple pain, especially if the tumor is located close to the nipple or if there is nipple retraction or discharge.
- Paget's disease of the breast: A rare form of breast cancer that affects the skin of the nipple and, sometimes, the areola, causing eczema-like changes and pain.
- Inflammatory breast cancer: A rare and aggressive form of breast cancer that can cause rapid breast swelling, redness, and pain, including nipple pain.
- Rare diagnoses
- Raynaud’s phenomenon of the nipple: A condition that affects blood flow to the nipples, causing pain and sometimes discoloration, often in response to cold or stress.
- Nipple adenoma: A rare, benign tumor of the nipple that can cause pain and nipple discharge.
- Neuroma of the nipple: A rare condition where nerve tissue in the nipple becomes damaged or inflamed, leading to chronic pain.