Does Nipple Discharge Color Predict (pre-) Malignant Breast Pathology?

Area of Science:

• Oncology
• Surgical Pathology
• Diagnostic Imaging

Background:

• Unilateral single-duct nipple discharge is a concerning symptom associated with breast malignancy.
• The diagnostic significance of nipple discharge color remains debated.
• Clinical and radiological examinations may not reveal abnormalities in early-stage malignancy.

Purpose of the Study:

• To evaluate the relationship between nipple discharge color and the risk of underlying breast malignancy.
• To assess the efficacy and safety of microdochectomy for diagnosing malignancy in patients with unilateral single-duct nipple discharge.

Main Methods:

• A prospective study included 184 patients with unilateral single-duct nipple discharge and normal clinical/radiological findings.
• Nipple discharge characteristics were recorded before microdochectomy.
• Logistic regression analysis was used to assess the association between discharge color and malignancy, adjusting for age.

Main Results:

• Breast carcinoma or high-risk lesions were found in 25% of patients.
• Bloody discharge was present in the majority of malignancy cases, but the association was not statistically significant for distinguishing high-risk patients.
• Patients over 60 years old had an increased risk of malignancy (OR: 2.35).
• Microdochectomy had a low complication rate (2.7%) and false-negative rate.

Conclusions:

• Unilateral single-duct nipple discharge warrants investigation for underlying malignancy.
• While bloody discharge is common in malignancy, it's not a reliable indicator alone.
• Microdochectomy is a safe and effective procedure recommended for all patients with unilateral single-duct nipple discharge to rule out malignancy.