Nipple Discharge

Question 1

These characteristitcs indicate what?

1) Serous -
2) Bloody-
3) Associated mass-
4) Unilateral-
5) Bilateral-

Answer 1

1) most likely benign fibrocystic changes (FCC) like duct ectasia
2) more likely neoplasticpapilloma or carcinoma
- —a) If there is bloody discharge, the bloody duct (and mass if present) should be excised
3) more likely neoplastic
4) neoplastic or non-neoplastic
5) most likely non neoplastic (Endocrine in etiology)

Question 2

Common causes of nipple discharge (in the non-lactating woman)

Answer 2

(1) Duct ectasia; type of FCC
(2) Intraductal papilloma; type of FCC
(3) Carcinoma

Question 3

Laboratory findings for nipple discharge

Answer 3

1) Cytological evaluation of discharge
- –(a) May identify malignant cells
- –(b) Negative finding does not rule out malignancy

Question 4

Imaging for nipple discharge

Answer 4

(1) Mammography and ultrasound
- -(a) When localized is not possible
- -(b) In the absence of a palpable mass

Question 5

Treatment for nipple discharge

Answer 5

(1) Would discuss with your supervising physician and refer to a breast clinic, OB/GYN, or General surgery depending on what type of discharge is present.
(2) Dependent on underlying cause
(3) Most discharge is benign especially if bilateral.
- –(a) Annoying or disconcerting to patients
(b) Duct excision can be offered

Question 6

Follow up nipple discharge

Answer 6

Patient should be reexamined every 3 to 4 months for a year if workup does not show malignancy.