Basal Cell Carcinoma of the Nipple-Areolar Complex

  • Kimberly A. ChunEmail author
  • Philip R. Cohen


Basal cell carcinoma (BCC) of the areola and nipple has been described in 35 men (median onset age, 61 years) and 20 women (median onset age, 66 years). The tumor occurred more frequently on the left side (54.9%) than the right side (45.1%). BCC of the nipple-areolar complex (NAC) is commonly presented as scaly or with ulcerated plaques and nodules. The pathologic type of BCC was most commonly nodular (42.9%) or superficial (30.9%). Although BCC of the NAC are frequently associated with a nonaggressive histologic subtype, they have been considered to behave more aggressively than BCCs at other anatomical sites. Complete excision of the BCC is the treatment of choice. Successful treatment of the primary tumor is rarely followed by cancer recurrence.


  1. 1.
    Rubin AI, Chen EH, Ratner D. Basal-cell carcinoma. N Engl J Med. 2005;353(21):2262–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Shertz WT, Balogh K. Metastasizing basal cell carcinoma of the nipple. Arch Pathol Lab Med. 1986;110(8):761–2.PubMedGoogle Scholar
  3. 3.
    Wysong A, Aasi SZ, Tang JY. Update on metastatic basal cell carcinoma: a summary of published cases from 1981 through 2011. JAMA Dermatol. 2013;149(5):615–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Robinson HB. Rodent ulcer of the male breast. Transact Pathol Soc London. 1893;44:147–8.Google Scholar
  5. 5.
    Wainwright JM. Carcinoma of the male breast. Arch Surg. 1927;14:836–59.CrossRefGoogle Scholar
  6. 6.
    Congdon GH, Dockerty MB. Malignant lesions of the nipple exclusive of Paget’s disease. Surg Gynecol Obstet. 1956;103(2):185–92.PubMedGoogle Scholar
  7. 7.
    Farrow JH. Benign and malignant lesions of the nipple. CA Cancer J Clin. 1958;8(1):16–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Wyatt AP. Basal cell carcinoma of the male breast. Proc R Soc Med. 1965;58(7):509–10.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Lupton GP, Goette K. Basal cell carcinoma of the nipple. Arch Dermatol. 1978;114(12):1845.CrossRefPubMedGoogle Scholar
  10. 10.
    Rahbari H, Mehregan AH. Basal cell epitheliomas in usual and unusual sites. J Cutan Pathol. 1979;6(5):425–31.CrossRefPubMedGoogle Scholar
  11. 11.
    Robins P, Rabinovitz HS, Rigel D. Basal-cell carcinomas on covered or unusual sites of the body. J Dermatol Surg Oncol. 1981;7(10):803–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Knudsen PJ. Basel cell carcinoma of the nipple. Ugeskr Laeger. 1982;144(12):876–7.PubMedGoogle Scholar
  13. 13.
    Bruce S, Tschen JA, Goldberg LH. Basal-cell carcinoma of the nipple. J Dermatol Surg Oncol. 1985;11(4):424–5.CrossRefPubMedGoogle Scholar
  14. 14.
    Nirodi NS, Mudd DG. Basal cell carcinoma of the male nipple. J R Coll Surg Edinb. 1986;31(2):121–3.PubMedGoogle Scholar
  15. 15.
    Cain RJ, Sau P, Benson PM. Basal cell carcinoma of the nipple. Report of two cases. J Am Acad Dermatol. 1990;22(2 Pt 1):207–10.CrossRefPubMedGoogle Scholar
  16. 16.
    Titzmann T, Peter RU, Thoma E, Ruzicka T. Pigmented basalioma as pseudomelanoma of the breast. Hautarzt. 1991;42(7):459–60.PubMedGoogle Scholar
  17. 17.
    Benharroch D, Geffen DB, Peiser J, Rosenberg L. Basal cell carcinoma of the male nipple. Case report and review of the literature. J Dermatol Surg Oncol. 1993;19(2):137–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Weber PJ, Moody BR, Foster JA. Series spiral advancement flap: an alternative to the ellipse. Dermatol Surg. 2001;27(1):64–6.PubMedGoogle Scholar
  19. 19.
    Betti R, Martino P, Moneghini L, Vergani R, Tolomio E, Crosti C. Basal cell carcinomas of the areola-nipple complex: case reports and review of the literature. J Dermatol. 2003;30(11):822–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Gupta C, Sheth D, Snower DP. Primary basal cell carcinoma of the nipple. Arch Pathol Lab Med. 2004;128(7):792–3.PubMedGoogle Scholar
  21. 21.
    Nouri K, Ballard CJ, Bouzari N, Saghari S. Basal cell carcinoma of the areola in a man. J Drugs Dermatol. 2005;4(3):352–4.PubMedGoogle Scholar
  22. 22.
    Kim JH, Oh JW, Shin DH, Kim SI, Park BW. Basal cell carcinoma of the nipple-areolar complex. J Korean Surg Soc. 2007;72:143–6.Google Scholar
  23. 23.
    Avci O, Pabuccuoglu U, Kocdor MA, Unlu M, Akin C, Soyal C, Canda T. Basal cell carcinoma of the nipple – an unusual location in a male patient. J Dtsch Dermatol Ges. 2008;6(2):130–2.CrossRefPubMedGoogle Scholar
  24. 24.
    Cummins DL, Yu Y, Finn DT. Island pedicle reconstruction of partial nipple and areola defect. Dermatol Surg. 2010;36(9):1459–62.CrossRefPubMedGoogle Scholar
  25. 25.
    Oram Y, Demirkesen C, Akkaya AD, Koyuncu E. Basal cell carcinoma of the nipple: an uncommon but ever-increasing location. Case Rep Dermatol Med. 2011;2011:818291.PubMedGoogle Scholar
  26. 26.
    Kacerovska D, Michal M, Kazakov DV. Basal cell carcinoma of the nipple extending into the lactiferous duct. Int J Surg Pathol. 2011;19(6):779–80.CrossRefPubMedGoogle Scholar
  27. 27.
    Sinha A, Langtry JA. Secondary intention healing following Mohs micrographic surgery for basal cell carcinoma of the nipple and areola. Acta Derm Venereol. 2011;91(1):78–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Williams C, Hussain W. A low-risk tumour, at a high-risk site? Basal cell carcinoma of the nipple-areola complex. Br J Dermatol. 2013;168(4):901–3.CrossRefPubMedGoogle Scholar
  29. 29.
    Brown PJ, Milch JM, Hivnor CM. Pigmented basal cell carcinoma of the nipple: a case report and review of the literature. Cutis. 2013;92(5):253–7.PubMedGoogle Scholar
  30. 30.
    Kalyani R, Vani BR, Srinivas MV, Veda P. Pigmented basal cell carcinoma of nipple and areola in a male breast – a case report with review of literature. Int J Biomed Sci. 2014;10(1):69–72.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Takeno S, Kikuchi N, Miura T, Anami K, Takahashi Y, Hashimoto T, Moroga T, Akizuki S, Kamei M, Suehiro S, Yamashita S, Kawahara K. Basal cell carcinoma of the nipple in male patients with gastric cancer recurrence: report of a case. Breast Cancer. 2014;21(1):102–7.CrossRefPubMedGoogle Scholar
  32. 32.
    Miglino B, Tiberio R, Astolfi S, Graziola F, Boggio P, Leutner M, Valente G, Franchini R, Colombo E. Basal cell carcinoma of the nipple in a male patient: a particular case report. Breast J. 2016;22(3):339–41.CrossRefPubMedGoogle Scholar
  33. 33.
    Kitamura S, Hata H, Yamaguchi Y, Imafuku K, Yanagi T, Shimizu H. The unique dermoscopic structure ‘Large black web’ in basal cell carcinoma on the areola. J Eur Acad Dermatol Venereol. 2016;30(12):e221–3.CrossRefPubMedGoogle Scholar
  34. 34.
    Davis AB, Patchefsky AS. Basal cell carcinoma of the nipple: case report and review of the literature. Cancer. 1977;40(4):1780–1.CrossRefPubMedGoogle Scholar
  35. 35.
    Jones R, Wayte DM, Mitchell E, Beer WE. Basal-cell carcinoma of the breast—treatment with retinoids. Clin Exp Dermatol. 1991;16(6):448–50.CrossRefPubMedGoogle Scholar
  36. 36.
    Betti R, Urbani CE, Lodi A, Crosti C. Unusual sites of basal cell epitheliomas according to anatomical distribution and relative tumor density index. Eur J Dermatol. 1992;2:82–4.Google Scholar
  37. 37.
    Wong SW, Smith JG Jr, Thomas WO. Bilateral basal cell carcinoma of the breasts. J Am Acad Dermatol. 1993;28(5 Pt 1):777.CrossRefPubMedGoogle Scholar
  38. 38.
    Nunez M, Marques A, de las Heras ME, Miralles ES, Ledo A. Bilateral basal cell carcinoma of the breasts in a woman. J Dermatol. 1995;22(3):226–8.CrossRefPubMedGoogle Scholar
  39. 39.
    Sauven P, Roberts A. Basal cell carcinoma of the nipple. J R Soc Med. 1983;76(8):699–701.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Sanchez-Carpintero I, Redondo P, Solano T. Basal cell carcinoma affecting the areola-nipple complex. Plast Reconstr Surg. 2000;105(4):1573.CrossRefPubMedGoogle Scholar
  41. 41.
    Yamamoto H, Ito Y, Hayashi T, Urano N, Kato T, Kimura Y, Tanigawa T, Endo W, Kurokawa E, Kikkawa N, Taniguchi H. A case of basal cell carcinoma of the nipple and areola with intraductal spread. Breast Cancer. 2001;8(3):229–33.CrossRefPubMedGoogle Scholar
  42. 42.
    Zhu YI, Ratner D. Basal cell carcinoma of the nipple: a case report and review of the literature. Dermatol Surg. 2001;27(11):971–4.PubMedGoogle Scholar
  43. 43.
    Huang CW, Pan CK, Shih TF, Tsai CC, Juan CC, Ker CG. Basal cell carcinoma of the nipple-areola complex: a case report. Kaohsiung J Med Sci. 2005;21(10):480–3.CrossRefPubMedGoogle Scholar
  44. 44.
    Rosen N, Muhn CY, Bernstein SC. A common tumor, an uncommon location: basal cell carcinoma of the nipple and areola in a 49-year-old woman. Dermatol Surg. 2005;31(4):480–3.CrossRefPubMedGoogle Scholar
  45. 45.
    Chu PY, Teng TH, Lee CC. Primary superficial basal cell carcinoma of the nipple. Ann Saudi Med. 2007;27(4):296–7.CrossRefPubMedGoogle Scholar
  46. 46.
    Jung HJ, Jun JH, Kim HY, Lee SJ, Kim do W, Lee WJ, Jung JH. Pigmented basal cell carcinoma of the nipple-areola complex in an elderly woman. Ann Dermatol. 2011;23(Suppl 2):S201–4.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Sharma A, Tambat RM, Singh A, Bhaligi DS. Basal cell carcinoma of the nipple areola complex. J Midlife Health. 2011;2(2):89–90.PubMedPubMedCentralGoogle Scholar
  48. 48.
    Xu D, Tian W, Li J, Song Y. The missing nipple: a rare case of basal cell carcinoma of the nipple in a Chinese female. Breast J. 2012;18(6):606–7.CrossRefPubMedGoogle Scholar
  49. 49.
    Trignano E, Manzo MJ, Paliogiannis P, Madonia M, Marongiu F, Lissia A, Campus GV. Basal cell carcinoma of the nipple-areola complex: report of a case and literature review. Ann Ital Chir. 2013;84(ePub).Google Scholar
  50. 50.
    Goddard L, Mollet T, Blalock T. Resident rounds: Part III. Plaque on left areola of an African-American woman. J Drugs Dermatol. 2014;13(6):767.PubMedGoogle Scholar
  51. 51.
    Ozerdem U, Hoda SA. Basal cell carcinoma of the nipple. Breast J. 2014;20(4):427–9.CrossRefPubMedGoogle Scholar
  52. 52.
    Alessi E, Venegoni L, Fanoni D, Berti E. Cytokeratin profile in basal cell carcinoma. Am J Dermatopathol. 2008;30(3):249–55.CrossRefPubMedGoogle Scholar
  53. 53.
    Pinkus H. Premalignant fibroepithelial tumors of skin. AMA Arch Derm Syphilol. 1953;67(6):598–615.CrossRefPubMedGoogle Scholar
  54. 54.
    Wallace SA, Halpert B. Trichoma: tumor of hair anlage. Arch Pathol (Chic). 1950;50(2):199–208.Google Scholar
  55. 55.
    Ferguson MS, Nouraei SA, Davies BJ, McLean NR. Basal cell carcinoma of the nipple-areola complex. Dermatol Surg. 2009;35(11):1771–5.CrossRefPubMedGoogle Scholar
  56. 56.
    Rogers HW, Weinstock MA, Harris AR, Hinckley MR, Feldman SR, Fleischer AB, Coldiron BM. Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Arch Dermatol. 2010;146(3):283–7.Google Scholar
  57. 57.
    Requena L, Sangueza M, Sangueza OP, Kutzner H. Pigmented mammary Paget disease and pigmented epidermotropic metastases from breast carcinoma. Am J Dermatopathol. 2002;24(3):189–98.CrossRefPubMedGoogle Scholar
  58. 58.
    Xiong YD, Ma S, Li X, Zhong X, Duan C, Chen Q. A meta-analysis of reflectance confocal microscopy for the diagnosis of malignant skin tumours. J Eur Acad Dermatol Venereol. 2016;30(8):1295–302.CrossRefPubMedGoogle Scholar
  59. 59.
    Gonzalez S, Tannous Z. Real-time, in vivo confocal reflectance microscopy of basal cell carcinoma. J Am Acad Dermatol. 2002;47(6):869–74.CrossRefPubMedGoogle Scholar
  60. 60.
    Menzies SW. Dermoscopy of pigmented basal cell carcinoma. Clin Dermatol. 2002;20(3):268–9.CrossRefPubMedGoogle Scholar
  61. 61.
    di Meo N, Damiani G, Vichi S, Fadel M, Nan K, Noal C, Trevisini S, Trevisan G. Interobserver agreement on dermoscopic features of small basal cell carcinoma (<5 mm) among low-experience dermoscopists. J Dermatol. 2016; doi:10.1111/1346-8138.13426.CrossRefPubMedGoogle Scholar
  62. 62.
    Chun KA, Cohen PR. Basal cell carcinoma of the nipple-areola complex: a comprehensive review of the world literature. Dermatol Ther (Heidelb). 2016;5(3):379–95.CrossRefGoogle Scholar
  63. 63.
    Wicking C, McGlinn E. The role of hedgehog signalling in tumorigenesis. Cancer Lett. 2001;173(1):1–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of DermatologyUniversity of California San DiegoSan DiegoUSA
  2. 2.San DiegoUSA

Personalised recommendations