The troublesome nipple shadow.

In a review of 1000 routine chest examinations, the nipple of the male or female breast was visible about 10% of the time. In 14 instances (1.4%), the reviewing radiologist thought that uncertainty of identification warranted additional films. In four of these instances, the density proved to be something other than nipple. In all other instances when a nipple shadow was identified (8.9%), follow-up was not deemed necessary for various, often somewhat subjective reasons. Thus the frequency of erroneous identification of nipples could have been higher. Certainty of nipple identification would have involved considerable cost and inconvenience in repeat examinations. In another group of 500 patients, identification of the nipple with a lead marker on all patients eliminated uncertainty and the necessity for any repeat examinations. The patients placed low cost markers at the time of disrobing. Convenience and certainty were served by this simple maneuver.