If you can exclude occasional pins and needles sensation in the nipple caused by nipple trauma, there are three main conditions to consider. First, cystic hyperplasia of the breast, the onset of which is mainly associated with endocrine hormone imbalance caused by breast hyperplasia and recuperation insufficiency. Typical clinical manifestations are breast swelling and pain, and can be accompanied by the formation of hyperplastic nodules in the breast. When the pain is obvious, it may spread to the nipple, which may cause occasional pins and needles sensation in the nipple. Secondly, intramammary ductal papilloma has no obvious clinical manifestations. However, when the tumor ruptures and bleeds, there may be pinprick pain in the nipple and bloody fluid may be spilled. Third, breast cancer, mostly seen in middle-aged and old women. There may be nipple stinging pain, and hard and poorly movable lumps can be touched in the breast, and the orange peel sign or dimple sign can be seen occasionally. Fourth, if a woman has nipple tenderness during breastfeeding, she should also consider acute mastitis.