Concerned about collection of symptoms - nipple

I have a qustion about my right nipple. In early June I noticed a scaling on top of my nipple, no itching, no redness, no discharge. However, it did not respond well to lanolin, so I made an appointment with my doctor. He prescribed a steroid cream, that seemed to take care of the scaling/peeling. However, I noticed that the nipple got smaller and harder in response to the cream (probably because of the steroids) and became a lighter pink. If I stopped the cream, a very light peeling would begin. I thought it could be a fungal infection and treated it with tinactin, to which it responded very well. The nipple still sometimes appears drier than the other one. But on exam (by two doctors), it seems just normal and much like the other side. My doctor ordered a mammogram and sonogram, both of which were negative for any masses at all. Now I have a localized burning/tenderness just outside of the areola...my doctor thinks it's fibrous tissue. I'm about to start my period, so will wait to see if it subsides after my cycle. Very frustrating having no definitive answers.  Do you hae any thoughts on this.  Should I be concerned?  Should I request a biopsy of the nipple, even though there is no evident rash or sore?

[CCF-RN,MSN-rf]

Dear cafleen:  Skin on the nipple is like skin anywhere else on the body and is subject to irritation, rashes etc.  These abnormalities are more common than Paget's disease of the nipple, which is a breast cancer.  Paget's disease of the nipple typically presents as bleeding, redness, itching and burning that does not go away.  If there is currently no scaling or other nipple irritation, there may not be anything to biopsy.  However, if you are concerned, a second opinion with a breast specialist may be a good option.