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Nipple discharge: surgical significance.

H P Leis1, F L Greene, A Cammarata

  • 1Breast Center, University of South Carolina School of Medicine, Columbia 29203.

Southern Medical Journal
|January 1, 1988
PubMed
Summary

Nipple discharge is a common breast symptom. Surgically significant discharges, like bloody or watery types, can indicate cancer or precancerous conditions, necessitating further investigation and potential surgical intervention.

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Area of Science:

  • Breast Surgery
  • Surgical Oncology
  • Pathology

Background:

  • Nipple discharge is a frequent breast complaint, second only to breast lumps.
  • Significant nipple discharge is defined as true, spontaneous, persistent, and nonlactational.
  • Various types of nipple discharge exist, including milky, purulent, watery, serous, serosanguineous, and sanguineous.

Purpose of the Study:

  • To evaluate the clinical significance of different types of nipple discharge.
  • To determine the incidence of cancer and precancerous mastopathy associated with surgically significant nipple discharge.
  • To outline management strategies for various nipple discharge presentations.

Main Methods:

  • Retrospective analysis of 7,588 patients undergoing breast surgery.

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  • Detailed review of 503 patients operated on for significant nipple discharge.
  • Correlation of discharge characteristics with histopathological findings, including cancer and precancerous mastopathy.
  • Main Results:

    • Among 503 surgically treated patients, 13.3% had cancer and 7.2% had precancerous mastopathy.
    • Cancer was detected in 11.9% of cases without a palpable mass and 16.4% with negative cytology.
    • The incidence of associated cancers increased with serous, serosanguineous, sanguineous, or watery discharge, and with patient age over 50.

    Conclusions:

    • Surgically significant nipple discharges warrant thorough investigation due to their association with malignancy.
    • Central duct excision is recommended for surgically significant discharges, except in specific patient groups.
    • Early diagnosis and appropriate management are crucial for favorable outcomes in patients with concerning nipple discharge.