A new surgical localization technique for biopsy in patients with nipple discharge

In a series of 12 patients with bloody nipple discharge, a new technique of mammary ductal localization was used to identify the duct responsible for the discharge and assure its complete removal for pathological diagnosis. This procedure utilizes a 30-gauge anterior chamber needle that is gently advanced into the offending duct, and methylene blue dye is injected to outline the involved duct for easy dissection though a circumareolar incision. This provides the pathologist with an intact specimen and avoids the problems associated with specimen roentgenography or loss of a ductal probe during the procedure. Because we feel that all patients with a bloody nipple discharge warrant a biopsy, this procedure provides a safe, rapid, effective method and allows the biopsy to be done on an outpatient basis.