White Nipple Lump: Evaluation Is Essential

A white lump on the nipple or areola requires clinical evaluation — it cannot be diagnosed by description alone.

Possible Causes

• Blocked nipple pore (bleb/milk blister): Common in lactation; white/yellow dot, painful.
• Montgomery gland cyst: Enlarged areolar gland; benign.
• Epidermal inclusion cyst.
• Paget's disease of the nipple: Rare adenocarcinoma — eczematous, crusted, ulcerated nipple; must be excluded.
• Subareolar abscess / duct ectasia.
• Benign tumor (papilloma, fibroadenoma).
• Malignant tumor.

Recommended Steps

1. See a breast specialist or primary care provider promptly.
2. Clinical breast exam.
3. Imaging: diagnostic mammogram (age ≥30) + targeted ultrasound.
4. Biopsy if imaging suspicious or Paget's suspected (punch biopsy of nipple skin).

Do not squeeze or manipulate. Most causes are benign, but Paget's and malignancy require early detection.