Expert: Claes-Gustaf Nordquist, M.D. - 9/27/2008

Question
QUESTION: Please clarify for me the bumps on the areola. Are the bumps on the areola itself called Montgomery's glands? Does the sebaceous gland come up from within the nipple itself and excrete through the nipple? Is this what the question of 06/06/08 is in reference to? I'm not sure which is correct. Thank you for your time, Terese

ANSWER: Yes the sebaceous glands in the areola of the nipple - and which forms bumps there - are called Montgomery's glands. They also exist on the nipple itself. So they excrete both on to the areola and to the nipple but they have nothing to do with milk ducts. These are separate things. Yes that question was about this.
Thanks! Yes men do have such glands. The purpose of them is not known with any certainty.



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QUESTION: Thank you, Dr. Nordquist. I realize the milk ducts and sebaceous glands are separate, but was wondering.... I'm a breast cancer survivor so my mind hasn't stopped wondering why and how. Do the sebaceous glands tie into the lymphatic system at all? The milk ducts do, don't they? If I'm becoming a bother I apologize, I just can't help myself, there are so many unanswered questions.Thank you, again. Terese

ANSWER: There are lymph vessels almost everywhere since they conduct tissue fluid ("lymph" fluid) back to the blood stream via the lymph node filters. So they do exist close to both milk ducts and sebaceous glands. Why is this important? Sebaceous glands are often connected with hair roots. In males there is often hair growth around the nipples (in some women too). And our early ancestors were probably quite hairy there - both males & females (as can still be seen in our "cousins", chimpanzees, bonobos, gorillas and orangutans). So it is actually not that surprising to find such glands there still.


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QUESTION: I was thinking about ductal carcinoma and why/how the cancer cells stay in the milk ducts and not spread into the sebaceous gland(s) when they both exit through the nipple. Could there ever be cancer in just the sebaceous gland? And if so, would it still be brest cancer?  The whole thing blows my mind!

Answer
Well a cancer could hardly spread via the nipple from a milk duct to a sebaceous gland since that would involve transportation ON THE OUTSIDE of the skin and INTO a sebaceous gland from the outside. Such a thing would be MOST unlikely to say the least! Cancer cells exposed to the outside world would be in a most hostile environment without any skin protection. the outermost cell layers of our skin are after all dead. And to enter a gland from the outside would not be very likely either. But sebaceous glands can indeed be INVADED by an advanced untreated breast cancer breaking through to the skin and breaking into such glands in the process. Or be invaded by the breast cancer form of the nipple called Paget's disease of the nipple (Paget also has a bone illness named after him that has nothing to do with cancer). So THAT IS possible. Yes a cancer COULD arise in a sebaceous gland. But since they are compared to milk glands in a breast both small in numbers and in volume and mass such a development is unlikely. Since it would happen in a breast it would be a breast cancer but its microscopical picture would to a pathologist be most atypical. A pathologist should most probably be able to see the difference. I have no statistics on this.
I do hope this answers your question!