Breast Cancer and the Areola

The areolas, the darker circular area around the nipple, are located where the mammary gland ducts reside in women's breasts. Changes during puberty, pregnancy, lactation, and menopause are all normal, and irritations can occur over time. Most irritations are normal, but some symptoms may point to early breast cancer, which primarily develops in the mammary ducts. This article outlines what breast conditions of the areolas to look out for.

Changes in the Areolas

During puberty the nipples are raised and the areolas darken, getting ready for the next stages of breast development, fully-formed breasts, during the teenage years, according to Stanford Children's Health. At this time, the breasts are developing and each month may change in texture during a typical menstrual cycle.

In the early stages of pregnancy, the breasts feel full, even itchy, and the areolas darken because the blood vessels become more visible. This is how the breasts prepare to breastfeed after a baby's birth. Between 15-20 small openings are located around the nipple from which milk is released during breastfeeding. The areola also contains "Montgomery glands" that are capable of producing some milk, but aren't the primary source of it.

During menopause, when the menstrual cycle ceases, the drop in estrogen, a naturally occurring hormone, can affect the shape and size of breasts. Some breasts will lose their elasticity, and the areolas may shrink.

Areolas and Breast Cancer

Areolas can change in color or size for many reasons, many of which are completely harmless. However, some changes are indicative of breast cancer. Knowing the different causes and expected changes can help you identify irregularities that might signal something more serious.

Every person has very different nipples and areolas, so do not try to compare yours to others as a sign of health or the presence of conditions. Instead, look for these signs:

• Bumps: Your nipples and areolas may have bumps when you're cold or stimulated. When those sensations subside, the bumps should fade. If you notice bumps or lumps that don't go away during your monthly self-exam, you should notify your healthcare provider. It can often be caused by minor issues like a small infection, but a persistent lump can also be a symptom of ductal carcinoma in situ or cancer inside the ducts. Only a biopsy will be able to determine if it's cancer or not. 
• Color Changes: During pregnancy or while breastfeeding, the areolas may go through significant changes in color and size. While this is normal, changes in color or size outside of pregnancy or breastfeeding may be a sign of other issues. If the areola skin appears thicker than normal, has a different texture similar to that of an orange peel or is inflamed, visit your healthcare provider. It could be a rash, but it could also be a symptom of a rare form of breast cancer called inflammatory breast cancer.  
• Pain: You may occasionally have sore or tender areolas around the nipple. While this is common, particularly at different times of your menstrual cycle, you should see a healthcare provider if the discomfort does not go away. 
• Mastitis: This is an infection that occurs in many people who are breastfeeding. It can be caused by a clogged milk duct. A warm compress can help, but if it continues for a few days, you should see a doctor who may prescribe an antibiotic.

Importance of Self-Exams

It's important to also examine the areolas and nipples during your monthly self-exam. Be aware of your body's normal appearance so that you can catch any changes or irregularities quickly. If you do find any irregularities, make an appointment to see your healthcare provider as soon as possible to undergo a medical screening.

When to See a Healthcare Provider

Most lumps and bumps in the breast are completely benign. But it's essential to get checked out to be sure. Irregularities, pain, or discharge are symptoms that should be examined by a medical professional. If something seems abnormal, your healthcare provider may order tests and send you to a radiologist for a mammogram or MRI , and/or a breast specialist. If it is breast cancer, seeking help right away will help you catch the disease early on, when it's easier to treat. 

Summary

Breasts go through many changes during the course of a woman's life, as well as specific times each month and with each pregnancy. It's important to know what feels and looks normal so that you'll know to see a healthcare provider if something feels or appears unusual for you.

A Word From Verywell

The good news is that many breast conditions are treatable and early detection of any condition, including breast cancer, can lead to better outcomes. If something feels "off" don't wait. You know your body better than anyone, and so you are the best caretaker of it. Make an appointment if you have any concerns.