II. History
- Nipple Scaling
- Nipple Retraction
- Redness or Warmth
- Skin thickening
- Dimpling
- Duration
- Location
- Changes
III. Normal Variation
- Montgomery glands- Prominent and visible as bumps around areola
 
- 
                          Nipple Inversion
                          - Congenitally present
- Differentiate from Nipple retraction
 
IV. Infections
- 
                          Intertrigo
                          - Commonly occurs in folds of pendulous Breasts
 
V. Abnormal Findings (Red Flags)
- Nipple retraction- Cancer until proven otherwise!
- Suggests retroareolar mass
 
- Paget's Disease of the Nipple
- Skin Retraction
- Skin Dimpling
- Peau d'orange- Breast skin dotted like skin of an orange- Not orange color
 
- Very ominous sign- Suggests Lymph Node involvement
 
 
- Breast skin dotted like skin of an orange
- 
                          Breast Erythema in non-lactating women- Ominous if persistent Mastitis greater than 2 weeks
- Suggests inflammatory carcinoma
 
