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Related Experiment Videos

A simple approach to nipple discharge.

T A King1, K M Carter, J S Bolton

  • 1Department of Surgery, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana 70121, USA.

The American Surgeon
|March 23, 2001
PubMed
Summary

Nipple discharge (ND) evaluation can be simplified. Diagnostic breast imaging followed by duct excision if negative is effective for managing ND, rarely revealing malignancy.

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Area of Science:

  • Breast Surgery
  • Oncology
  • Diagnostic Imaging

Background:

  • Nipple discharge (ND) management aims to detect malignancy and alleviate bothersome symptoms.
  • A simple, effective algorithm for ND evaluation is needed.

Purpose of the Study:

  • To develop and evaluate a straightforward algorithm for managing patients with nipple discharge.
  • To determine the diagnostic yield of various investigations for ND.

Main Methods:

  • Retrospective review of 104 patients with nipple discharge from December 1996 to June 1999.
  • Analysis of diagnostic breast imaging (mammography, ultrasound), biopsies, duct excision, and nonoperative management.
  • Evaluation of tests including ductography, cytology, and laboratory studies.

Main Results:

  • Of 104 patients, 11 with imaging abnormalities underwent biopsy, revealing 3 malignancies.
  • The remaining 93 patients had negative imaging; 39 underwent duct excision with only 1 malignancy found.
  • No malignancy was identified in patients managed nonoperatively with negative imaging.

Conclusions:

  • Malignancy is uncommon in nipple discharge when diagnostic breast imaging is negative.
  • A recommended algorithm involves diagnostic breast imaging; if negative, duct excision should be considered.
  • Ductography, cytology, and laboratory studies have limited roles in evaluating nipple discharge.

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