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.