Is it mandatory to remove lump behind the nipple with mild mastitis?

Q. Mammogram for lump behind nipple shows distended ducts and I feel pain while feeding. Please help.

Answered by
Dr. Ismail Mikdat Kabakus
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 22, 2020 and last reviewed on: Feb 08, 2021

Hello doctor,

I have had a mammogram and ultrasound done for a lump behind my nipple. I am breastfeeding my ten months old and it does not appear to be a blocked duct. It is painful while feeding. It is present for two weeks and awaiting mammogram results. I would like to have clarification of films to help with anxiety while I wait for a breast surgeon appointment.

More details about the presenting complaint:

Unable to clear anything, no signs of mastitis or blocked milk behind. Ultrasound report said distended ducts.

Previous history of the same issue:

Investigated for pagers nipple disease 5 years ago due to dermatitis on the nipple area for four months.



Welcome to

I totally understand your concern.

First of all, there is no suspicious mass on the mammogram (attachment removed to protect patient identity). Secondly, breast tissue is more prominent on the right, which might happen during lactation depending on which side you use more for breastfeeding and mild mastitis. Lastly, the lump you feel might be a small lymph node.

In a nutshell, there is no suspicious lesion on the mammogram. Please let me know if you have any further questions.

The Probable causes:

Asymmetric breast tissue, mild mastitis.

Preventive measures:

Breastfeeding with the normal side.

Thank you doctor,

The lump can be felt in the actual nipple. When rolled in the fingers, blanching of the nipple skin can be seen where the lump is underlying. I am assuming that is what is seen in the film on the left hand side. I am assuming the contents of the lump will need to be removed. Am I right?



Welcome back to

If it is actually in the nipple, it is most likely obstructed duct or cyst. I do not believe it has to be removed. I suggest it to be followed. If it goes away perfect. If not, you can have a repeat ultrasound. Surgery is the last resort since its risk of being mass is very low.

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