Inverted Nipples

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.

Are Inverted Nipples a Sign of Breast Cancer?

Julie Marks is a freelance writer with more than 17 years of experience covering health, lifestyle, parenting, science, and medical topics.

Published on December 15, 2022

Lauren Schlanger, MD, is a board-certified primary care physician. She is an assistant professor at the Alpert Medical School of Brown University.

Table of Contents
Table of Contents

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.

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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.

stefanamer / Getty Images

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

Other Causes of Inverted Nipple

Inverted nipples don’t always signify cancer. You can be born with them, or they can result from other conditions, such as:

• Infections
• Aging or sagging breasts
• Surgical procedures
• An injury to the breast
• Breastfeeding
• Mammary duct ectasia (a condition that causes milk ducts to widen and thicken)

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.

Treating Noncancerous Inverted Nipples

If a nipple is inverted due to an infection, antibiotics may be necessary. There are also cosmetic procedures available to improve the appearance and function of the nipple. Some women perform specific exercises or use suction devices to help “pop” their nipples out, so they can effectively breastfeed.

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.

Frequently Asked Questions

How many people have inverted nipples without cancer?

About 2% of people are born with inverted nipples. Most people with inverted nipples are born with them or develop them slowly over time. It’s less common for inverted nipples to be associated with cancer.

Do inverted nipples happen with age?

Yes. As you age, you’re more likely to develop inverted nipples. They are common in people with sagging breasts.

Is sudden nipple inversion a sign of breast cancer?

Yes. Sudden nipple inversion is more concerning than nipple inversion that comes on slowly or that you’ve had since birth.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. National Cancer Institute. Understanding breast changes.
2. Del Riego J, Pitarch M, Codina C, et al. Multimodality approach to the nipple-areolar complex: a pictorial review and diagnostic algorithm, Insights Imaging. 2020 Dec;1:89. doi:10.1186/s13244-020-00896-1
3. HealthyWomen.org. Inverted nipples.
4. Killelea, B and Sowden, M. Nipple Inversion. UpToDate.
5. American Cancer Society. Paget disease of the breast.
6. Breastcancer.org. Ductal carcinoma in situ.
7. La Leche League International. Inverted and flat nipples.

Inverted Nipples

Nipples that are inverted or retracted point inward toward the breast or lay flat instead of pointing outward. Most people with inverted nipples are born with them. And usually they’re harmless. If one or both of your nipples inverts suddenly, though, this could be a sign of an issue that requires medical attention. Schedule an appointment with your healthcare provider to get checked out.

Overview

Inverted nipple compared to a typical nipple.

What are inverted nipples?

Inverted nipples point inward toward your breast instead of outward. Sometimes, people use the word “inverted” to refer to nipples that are “retracted,” too. Retracted nipples lay flat on the circle of pigmented skin that surrounds your nipple (areola). You may have inverted nipples in one breast or both. Your nipples may lay flat, be turned slightly inward, or they may be drawn so deeply into your breast that they can’t be pulled out without surgery.

A grading system is used to classify the extent of nipple inversion.

• Grade 1. You can pull your nipple out with your fingers, and it will stay pointed outward for a few minutes before returning inward or going flat again.
• Grade 2. You can pull your nipple out with your fingers, but it will turn back inward as soon as you let your nipple go. Most people with inverted nipples are considered grade 2 inversion.
• Grade 3. Your nipple can’t be pulled out with your fingers.

What does it mean if your nipple is inverted?

Having an inverted nipple may be completely harmless, or it may signal an underlying issue that requires medical attention. Most people with inverted nipples are born with them or get them gradually. This usually isn’t a sign of a problem. The only time you should be concerned is if your nipples invert suddenly. A nipple inverting out of the blue can signal an infection, an injury, or another issue that you should discuss with your healthcare provider.

Who does it affect?

Anyone can be born with inverted nipples. But you’re more likely to develop them if:

• You’re a cisgender woman who’s approaching menopause. Beginning in their mid-30s and leading up to and beyond menopause, cisgender women may get inverted nipples in their breasts as their milk ducts shorten and widen.
• You’re breastfeeding. People who are breastfeeding are more likely to experience injury to their mammary ducts that can cause their nipples to invert.
• You smoke tobacco products. People who smoke are more likely to get infections in their breasts that cause inverted nipples.

How common are inverted nipples?

Approximately 3% to 10% of cisgender women are born with inverted nipples, but anyone can have them. About 87% of cisgender women born with inverted nipples have them in both breasts.

Symptoms and Causes

What causes inverted nipples?

Inverted nipples have many causes. Figuring out what’s causing the inversion is important because some of these changes are harmless. Others require medical attention.

Breast injuries

Breast trauma from surgery or even breastfeeding can change the tissue in your milk ducts so that your nipple gets pulled inward.

• Scarring from Your milk ducts can scar as a result of breastfeeding, causing your nipples to invert.
• Complication following abreast reduction. The milk ducts beneath your nipple can get inflamed after surgery, causing your nipples to invert.

Infection and inflammation

Your mammary ducts can clog and become infected, and these changes can cause inverted nipples. Anyone with breasts can experience these changes, but the risks increase if you’re perimenopausal. You may experience these changes after menopause, too.

• Mammary duct ecstasia. One or more milk ducts beneath your nipple get clogged and possibly infected, causing your nipple to pull inward.
• Bacteria enter your breast through a milk duct or a crack in your nipple, causing an infection that causes your nipple to invert.
• Abscess under your areola. Pus collects underneath your areola, causing an infection that inverts your nipple.

Breast cancer

Inverted nipples can be a sign of cancer.

• A tumor attacks a milk duct behind your nipple, causing it to invert.
• Paget’s disease. Cancer cells attack one of your nipples, causing it to invert.

What are the symptoms?

Your symptoms will depend on what’s causing your inverted nipples.

Signs of inflammation or infection may include:

• Breasts that are tender and warm to the touch.
• Redness in your nipple area.
• A lump behind your nipple.
• Bloody discharge coming from your nipple.
• Discharge from your nipple that’s white, green or black.

Signs of cancer may include:

• A lump in your breast.
• Pain in your breast.
• Swelling in your nipples and a discharge.
• Changes in your skin, like dimpling, itchiness, flaky or scaly skin.

Most importantly, pay attention to how quickly your nipple went from facing outward to becoming inverted. Contact your healthcare provider if the change was sudden.

Diagnosis and Tests

How are inverted nipples diagnosed?

Your healthcare provider will do a breast exam, taking care to look closely at your areola and nipples. The procedures and tests that follow will depend on what conditions your provider rules out based on the breast exam and your symptoms. Common procedures used to diagnose what’s causing inverted nipples include:

• Mammogram.
• Breast ultrasound.
• Breast MRI.
• Needle biopsy.

Management and Treatment

How are inverted nipples treated?

Your healthcare provider can recommend treatments based on what’s causing your inverted nipples. They can address any aesthetic concerns, too.

• Your provider will prescribe antibiotics to treat an infection. If you have an abscess, your provider can drain it or remove it surgically.
• Your treatment will depend on how advanced the cancer is. Your provider may recommend hormone therapy, chemotherapy or radiation. Or, they may suggest surgery that involves removing the lump or the breast with the affected nipple.
• Cosmetic concerns. Your provider can recommend surgery if you’re unhappy with the way that your nipples look. Healthy nipples come in all varieties, including inverted. But, if your nipples are making you feel self-conscious, your provider can recommend cosmetic procedures that can boost your confidence.

How do I get my inverted nipples to stick out?

If you’re having trouble turning your nipples outward to breastfeed, there are simple techniques you can try to coax them out.

• Hoffmann technique. Place your thumbs on either side of your nipple. Then, press down while pulling your thumbs apart to encourage your nipple to pop up so that your baby can latch.
• Nipples are erectile tissue. Gently place your thumb and forefinger around your nipple and make a rolling motion or apply cold to it to encourage it outward. Side-lying while doing this and feeding your baby can make this even more successful.
• Your baby is often the best tool to draw the nipple out but you can also use a suction device like a breast pump to draw out your nipple. Please note, your baby should be latching onto your areola and not your nipple so often getting a deeper latch can solve latching troubles as well.

If these methods fail, consider consulting a lactation consultant or breastfeeding medicine physician who can provide tips to help your newborn latch correctly so that you can breastfeed.

Prevention

How can I reduce my risk of getting inverted nipples?

You can’t prevent inverted nipples, but you can reduce your risk of getting an infection by choosing not to smoke. The majority of people who have a long-lasting inflammation in their breast called periductal mastitis smoke tobacco products. Nipple inversion is just one symptom of this condition.

Outlook / Prognosis

Do inverted nipples ever go away?

Inverted nipples don’t usually go away on their own. If you’re concerned about their appearance, speak with your provider about surgical options. Or, ask your provider about options for training your nipple outwards, like the Hoffmann technique. Your provider can discuss short-term and long-term solutions based on what’s causing your nipples to invert and what grade of inversion they are.

Living With

When should I see my healthcare provider?

Your provider needs to know if you’ve noticed sudden changes in your breast, like inverted nipples. This change may signal an underlying issue that requires treatment.

Frequently Asked Questions

Is it OK to have inverted nipples?

Don’t worry about having inverted nipples unless this is a recent change and a medical issue is to blame. Many people are born with nipples that are turned inward. There isn’t one right way that a nipple should be positioned on your breast.

A note from Cleveland Clinic

When it comes to inverted nipples, timing is important. If you’ve always had them, there’s probably no need to worry. But if this change appeared suddenly, you may have a condition that your provider needs to know about. Don’t delay seeking care. And if your concerns are primarily cosmetic, your provider can help you with that, too.