An 80-year-old woman with left breast cancer was treated with breast-conserving surgery. After 22 years, she visited our hospital with a chief complaint of bloody secretion from left nipple. A biopsy showed ductal carcinoma, and she was diagnosed with nipple recurrence of breast cancer. She underwent total mastectomy of left breast, and final pathological examination diagnosed ductal carcinoma in situ. Adjuvant therapy was not performed, and the she is currently recurrence-free 6 months after surgery. A single recurrence in the nipple area more than 20 years after breast-conserving surgery is rare, but a good prognosis is expected. Adequate treatment strategies for late recurrence are important.