Is that white speck on your breast nipple more likely to be a melanoma than a harmless cyst or some other benign condition?

When you do breast self-exams, the emphasis is often on what your fingertips can feel.

However, visual inspections of your breasts are equally important, as cancer can reveal itself by a change in appearance.

Have you recently discovered – either during a self-exam or accidentally – a white speck on a nipple that can’t be rubbed off?

Melanoma can grow anywhere, including areas that have not gotten much sunlight, or any sunlight at all, for that matter.

A new spot on a nipple can easily evoke anxiety in a health conscious individual.

Melanoma on a breast nipple? 

“While white spots on the nipples are not usually a cause for concern and are often related to pregnancy or breastfeeding, it is important to be aware of the potential signs of melanoma,” explains Cameron K. Rokhsar, MD, a double board-certified dermatologist and owner of New York Cosmetic, Skin & Laser Surgery Center.

“Melanoma is a type of skin cancer that can develop anywhere on the body, including the breast area.

“While uncommon, melanoma can develop on the nipple and areola.

“Signs of melanoma include asymmetrical skin spots, irregular borders, changes in color and a diameter greater than one-fourth inch (about six millimeters).”

NOTE: These are common signs of melanoma. Some melanomas breach these rules. For instance, a melanoma can be only two millimeters.

Two-thirds of melanomas arise in the absence of a pre-existing mole.

“Melanoma may also evolve and change over time,” adds Dr. Rokhsar.

Can a melanoma be white?

“There is a form of melanoma, called amelanotic melanoma, which is colorless,” says Dr. Rokhsar.

“These are the toughest melanomas to diagnose and are often missed even by board certified dermatologists.

“This is because they do not possess the morphologic changes utilized by most dermatologists to diagnose melanomas.”

The colorless nature of an amelanotic melanoma could present as a hue resembling your natural light skin color, blending in; or, it can appear pink, a pinkish-flesh colored or whitish, especially against the background of the nipple.

What else can be a white spot on a breast nipple?

“Other potential causes of white spots on the nipple include Montgomery glands, which are responsible for lubricating the nipple and areola during lactation, or eczema, a treatable skin rash,” says Dr. Rohksar.

Three Montgomery glands are visible as very light colored, tiny bumps on the areola. Electric one, CC BY-SA 3.0

“However, if you notice any changes in the texture or appearance of your nipple or areola, it is important to seek medical attention from a qualified healthcare provider.

“A dermatologist or breast specialist can examine the area and provide a diagnosis, and if necessary, perform a biopsy or other diagnostic testing to rule out melanoma or other types of breast cancer.” 

At New York Cosmetic, Skin, and Laser Surgery Center, Cameron K. Rokhsar, MD, FAAD, FAACS, and his team provide exceptional skin care solutions for many conditions and skin diseases including all types of skin cancer. Dr. Rokhsar is board certified in dermatology and dermatologic surgery.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 


Top image: SShutterstock/tuart Jenner