Muscle Nipples
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Muscle Nipples
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Pam Stephan is a breast cancer survivor.
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Oncology Certified Nurse Practitioner and freelance healthcare writer with over a decade of medical oncology and hematology experience.
Jason DelCollo, DO, board-certified in family medicine. He is associate faculty at Philadelphia College of Osteopathic Medicine as well as adjunct faculty with the Crozer Family Medicine Residency Program, and is an attending physician at Glen Mills Family Medicine in Glen Mills, Pennsylvania.
The anatomy of the female breast is complex and intricate. The breast is made up of milk ducts, lobes, lobules, lymph nodes, and vessels on the inside, and the nipple and areola on the outside.
The primary function of the female breasts is to produce breast milk and breastfeed a baby. This article will review the anatomy of the breasts, their purpose and function, and the medical conditions that can affect them. 1
The female breast is made up of multiple types of tissue, including: 1
The nipple is in the center of the breast, and it's surrounded by the areola. Each nipple contains milk duct openings through which breast milk flows.
Nipples are held erect by small, smooth muscles that respond to signals from your autonomic nervous system . Nipple erection can be caused by cold temperature or stimulation. 2
Paget's disease of the nipple is a rare form of breast cancer that accounts for less than 5% of breast cancer cases. In this condition, cancer cells usually travel from the milk ducts and spread to the nipple's surface and the areola, causing them to become itchy, red, and scaly. 3
Surrounding the nipple is the areola , an area of skin that is darker than the rest of the breast. The areola may be small or large, round or oval. During pregnancy, the areolas often grow in diameter and may remain larger (and sometimes darker) even after pregnancy. 4
There are small bumps on the areola. These are either hair follicles or Montgomery glands, which are sebaceous (oil) glands.
If you notice any changes in the areola, such as dimples, puckers, or a rash, notify your healthcare provider. These might be harmless, but could also be symptoms of Paget's disease. 3
Tenderness or a hard lump beneath the areola may also be symptoms of a subareolar abscess , cancer , or a noncancerous infection that may need to be drained. 5
Montgomery glands are small glands that lie just below the surface of the areola and look like small bumps on the skin. Also called areolar glands or Montgomery tubercles, these provide lubrication during breastfeeding and have a scent that attracts the infant to the breast. 6
Montgomery glands may become blocked, like pimples, and become swollen. A cyst may develop beneath a blocked gland. This can feel uncomfortable, but it is not a sign of breast cancer.
Each breast has 15–20 lobes that contain clusters of lobules, which produce breast milk. Each lobe has 20–40 lobules. 7
Invasive lobular carcinoma (ILC) accounts for 10% of breast cancers. ILC starts in the breast’s lobules and invades surrounding tissue. ILC can feel like a thick or full area that feels different than the rest of the breast. 8
Noncancerous conditions that can affect the lobes and lobules are lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH). These consist of abnormal cells. Though they aren't cancerous themselves, having them raises your risk of breast cancer in the future. 9
Glandular tissue includes the lobules, which produce breast milk, and ducts, the tubes that carry milk to the nipple. 10
Milk ducts are small tubes that transport milk from the milk glands (the lobules in the breast) out to the tip of the nipple.
Breast milk is released from tiny openings at the surface of the nipple. There are typically two or three of these holes in the center of your nipple, and three to five more arranged around the center. These holes have tiny sphincters (valves) that close to prevent leakage when not breastfeeding. 1
The ducts just below the areola widen before they enter the nipple. This wide, saclike area is called an ampulla.
Invasive ductal carcinoma originates in the milk ducts; it is the most common type of breast cancer, accounting for 80% of cases. 8 Ductal carcinoma in situ , which also originates in the ducts, is a noninvasive form of ductal cancer. 9
During breastfeeding, a milk duct can become plugged, leading to an infection called mastitis. Mastitis can be very uncomfortable but usually responds well to heat and antibiotics. 11
The internal mammary artery, which runs underneath the main breast tissue, is the primary source of the breast's blood supply. The blood supply provides oxygen and nutrients to the breast tissue. Other blood vessels include the thoracoacromial artery, lateral thoracic artery, as well as capillaries and veins. 12
During a nipple-sparing mastectomy, a surgeon may temporarily remove and then replace the nipple in order to remove any breast cells that may contain cancer. This can, however, disrupt the tiny blood vessels, leading to loss of your nipple later on. Maintaining the blood supply in the nipple helps to keep these tissues alive after a mastectomy .
Lymph vessels transport lymph, the fluid that helps your body’s immune system fight infection. Lymph vessels connect to lymph nodes found under the armpits, in the chest, and elsewhere in the body. 12
A rare but aggressive type of breast cancer, called inflammatory breast cancer (IBC), occurs when cancer cells block lymph vessels in the skin, which then causes inflammation in the breast. Symptoms of IBC include dimpling or thickening of breast skin and may look and feel like an orange peel. Other symptoms include breast swelling, itching, and breast skin that is red or purple. 13
The breast's lymph system plays a role in the diagnosis and treatment of breast cancers overall. Cancer cells can travel through lymph vessels into the lymph nodes, move through the bloodstream, and spread to other organs, leading to metastasis. 12
Breasts contain a network of nerves, with many sensitive nerve endings found in the areola and nipple. These nerves make the breasts sensitive to touch, cold, and a nursing baby. When a baby begins nursing, nerves are stimulated to release milk from the milk ducts. This is called the let-down reflex and can cause a tingling sensation. 14
Sometimes after a mastectomy, when the full breast has been removed, there can be nerve pain or discomfort that remains, called post-mastectomy pain syndrome. This can cause numbness or tingling in the wall of the chest and occurs due to changes in the nerves that occur after surgery. 15
The breasts lie on top of the pectoral muscles, which extend from the breastbone up to the collarbone and into the armpit. Their main purpose is to control movement in the arm and shoulder, but they are also connected to the breasts.
The breasts themselves do not contain any muscles. Instead, they are supported by a framework of fibrous bands of tissue called Cooper's ligaments, which form a "hammock" for the breast tissue to keep its shape. These ligaments run from the collarbone and chest wall throughout the breast and up to the areola. The ligaments can stretch over time, causing the breast to sag. 16
"Mastalgia" is a term that means breast pain, and this can have many causes. One type of pain is referred pain, which feels like the breast hurts but is actually caused by inflammation or injury to the muscular chest wall under the breast. Another cause of mastalgia can be pain from the ligaments in the breast as they are being stretched. 17
Hair follicles are present on the outer breast, usually on the surface of the areola. Due to these follicles, it is not unusual to have a few hairs growing on the areola or breast skin.
A condition called folliculitis can occur in the hair follicles. With folliculitis, the follicle around the hair becomes inflamed and may be red, swollen, and painful. A boil can form if an infection in the inflamed follicle goes deeper into the surface. 18
The breasts contain many structures that are important to support their purpose—producing milk. Understanding its anatomy and how it functions can be important information, especially if someone is interested in breastfeeding. It is also important to become familiar with your breasts so you can determine what's normal for you and what's not.
The female breast is a complex organ. Many conditions can affect the various structures of the breasts. When something seems abnormal, people often worry that it is due to cancer. However, it more often is not.
If you are concerned by any changes in how your breasts look or feel, contact your healthcare provider for an evaluation.
Although breasts are not reproductive organs, they have an important function in reproductive health, as they are able to produce milk to nourish an infant. 19
The entire breast may be uncomfortable in early pregnancy. As hormones are changing the breasts and preparing them for milk production, the skin, lobes, and nipples may all feel uncomfortable. As the breast size increases, the ligaments in the breast stretch and may feel painful. 20
National Cancer Institute. Breast anatomy .
Zucca-Matthes G, Urban C, Vallejo A. Anatomy of the nipple and breast ducts . Gland Surg . 2016;5(1):32-36.
National Organization for Rare Disorders. Pagets disease of the breast .
Alex A, Bhandary E, McGuire KP. Anatomy and physiology of the breast during pregnancy and lactation . Adv Exp Med Biol . 2020;1252:3-7. doi:10.1007/978-3-030-41596-9_1
U.S. National Library of Medicine. Medline Plus. Subareolar abcess .
American Cancer Society. Invasive breast cancer .
Centers for Disease Control and Prevention. What does it mean to have dense breasts?
University of Michigan Health. Mastitis while breastfeeding.
Rivard AB, Galarza-Paez L, Peterson DC. Anatomy, thorax, breast . StatPearls.
American Cancer Society. Inflammatory breast cancer .
American Academy of Family Physicians. Familydoctor.org. Breastfeeding: Tips to get you off to a good start .
Stonybrook University Hospital. General breast health .
Zucca-Matthes G, Urban C, Vallejo A. Anatomy of the nipple and breast ducts . Gland Surgery . 2016;5(1):32-36.
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