Nipple Discharge

Question 1

What are the general considerations for nipple discharge?

Answer 1

Serous-benign fibrocystic changes like duct ectasia
Characteristics of nipple discharge need to be evaluated by history and physical examination

Question 2

What are some general considerations with nipple discharge cont?

Answer 2

Bloody- more like neoplastic (papilloma or carcinoma)
Associated mass- more likely neoplastic
Unilateral- neoplastic or non
Bilateral- most likely non

Question 3

What are some of the common causes?

Answer 3

Duct extasia; type of FCC
Spontaneous unilateral serous or serosanguinous discharge from single duct

Introductal papilloma; type of FCC
Spontaneous, unilateral, serous or serosanguinous discharge from a single duct

Carcinoma
Bloody discharge

Question 4

What are some of the other causes?

Answer 4

Milky discharge in the non lactating woman may occur from hyperprolactinemia
Oral contraceptive or estrogen replacement
Breast abcess

Question 5

What are some of the laboratory findings?

Answer 5

May find malignant cells

Question 6

How do you treat nipple discharge?

Answer 6

Refer to a breast clinic, OB/GYN, or general surgery depending on what type of discharge is present.
Dependent on underlying cause.
Most discharge is benign.
-annoying or disconcerting to patients
-duct excision can be offered
If an was must be removed.