Supernumerary nipples (syn. accessory nipples)

A supernumerary nipple is a common, minor malformation of mammary tissue resulting in an extra nipple/s, and/or associated tissue. Most supernumerary nipples do not cause symptoms or complications.

This chapter is set out as follows:

• Supernumerary nipples (or breasts) are found in up to 6% of the population
• Most cases are sporadic, however, they are occasionally familial with an autosomal dominant pattern of inheritance with incomplete penetrance. Uncommonly, they are associated with genetic syndromes

• Present at birth 

• Most are much smaller than the normal areola and nipple. They may be solitary or multiple, arising on one or both nipple line(s)
• Lesions may be pink or brown, the central nipple is elevated off the skin surface
• If the supernumerary nipple contains glandular tissue, it can enlarge during puberty, swell, and become tender premenstrually, and undergo lactation
  

Most people do not need treatment. Removal via surgery or another technique may be considered for cosmetic purposes or if there are symptoms that cause discomfort, such as lactation or tenderness.

A thorough work-up for other malformations typically is not needed in a person with a supernumerary nipple who is otherwise healthy. However, a work-up may be recommended if a person has any of the following (refer to the Genetic and Rare Disease Information Centre for more information):

• A supernumerary nipple accompanied by additional minor malformations
• A prominent ectopic (abnormally positioned) supernumerary nipple
• An established family history of supernumerary nipples

Supernumerary nipples can undergo similar disease processes to normal breast tissue, and patients with glandular tissue require physical exams and mammography at the frequency recommended for normal breast tissue.