Treatment of the benign inverted nipple: A systematic review and recommendations for future therapy

Abstract The inverted nipple is a frequently encountered problem which can cause difficulties with breastfeeding, sexuality, and aesthetic dissatisfaction. Up to now, no consensus exists on a preferred treatment method. We performed a systematic review to identify the best treatment method for corre...

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Bibliographic Details
Published in:	Breast (Edinburgh) Vol. 29; pp. 82 - 89
Main Authors:	Hernandez Yenty, Q.M, Jurgens, W.J.F.M, van Zuijlen, P.P.M, de Vet, H.C.W, Verhaegen, P.D.H.M
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Ltd 01-10-2016
Subjects:	Adolescent Adult Depressed nipple Female Forecasting Hematology, Oncology and Palliative Medicine Humans Inverted nipple Middle Aged Nipples - abnormalities Nipples - injuries Nipples - surgery Reconstructive Surgical Procedures - adverse effects Reconstructive Surgical Procedures - methods Reconstructive Surgical Procedures - trends Retracted nipple Systematic review Young Adult Inverted nipple Systematic review Retracted nipple Depressed nipple
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Summary:	Abstract The inverted nipple is a frequently encountered problem which can cause difficulties with breastfeeding, sexuality, and aesthetic dissatisfaction. Up to now, no consensus exists on a preferred treatment method. We performed a systematic review to identify the best treatment method for correction of benign inverted nipples. Treatment techniques were subdivided in the categories lactiferous duct preserving and lactiferous duct damaging. A systematic review was performed using the PRISMA statement. Inclusion criteria were: female patients with congenital or acquired inverted nipples, a minimum sample size of 10 nipples, and studies reporting recurrence of inversion with a minimum follow-up of six months. Exclusion criteria were nipple inversion caused by malignancy. Thirteen studies met the inclusion criteria which all had a level of evidence IV. No non-invasive treatment techniques were identified. In the duct preserving category eight studies were included with a recurrence rate of 0.6% (2/350) versus 9.9% (16/161) in the duct damaging category (n = 5). Other outcome parameters were not systematically reported in all studies. Because of a small number of low quality studies with heterogeneous interventions and outcomes a meta-analysis could not be performed and no preferred treatment method was identified. Based on the available data there is no statistical evidence that duct damaging treatment is superior to duct preserving treatment. We recommend that the first method of choice should be a duct preserving treatment method. In the future, more studies of better methodological quality are required and recommendations were made on how these could be conducted.
Bibliography:	SourceType-Scholarly Journals-1 ObjectType-Feature-4 ObjectType-Undefined-1 content type line 23 ObjectType-Review-2 ObjectType-Article-3
ISSN:	0960-9776 1532-3080
DOI:	10.1016/j.breast.2016.07.011