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Management of nipple discharge
H Gülay1, S Bora, S Kìlìçturgay
1Dokuz Eylül University Hospital, Department of General Surgery, Izmir, Turkey.
Journal of the American College of Surgeons
|May 1, 1994
Summary
Nipple discharge in women can stem from benign or malignant causes. Further investigation like biopsy is recommended, especially if a breast mass is present, to accurately diagnose the cause.
Area of Science:
- Oncology
- Pathology
- Surgical Breast Disease
Background:
- Nipple discharge is a common breast symptom, necessitating accurate diagnosis.
- Understanding the correlation between nipple discharge characteristics and underlying breast pathology is crucial for patient management.
Purpose of the Study:
- To analyze the causes of nipple discharge in a large cohort of women.
- To determine the diagnostic yield of biopsy and subareolar exploration for nipple discharge.
- To compare the incidence of malignancy in patients with and without a palpable mass.
Main Methods:
- Retrospective analysis of 9,312 women presenting with breast disease.
- Categorization of nipple discharge as spontaneous or provoked.
- Biopsy or subareolar exploration performed based on clinical findings (palpable mass vs. discharge only).
Main Results:
- Nipple discharge occurred in 4.8% of patients; intraductal papilloma was the most frequent benign cause (47.8%).
- Carcinoma was diagnosed in 14.4% of spontaneous discharge cases and 2.9% of provoked discharge cases.
- Malignancy incidence was significantly higher (61.5%) in patients with a palpable mass compared to those with discharge only (6.1%).
Conclusions:
- Nipple discharge warrants investigation, with biopsy or exploration guided by the presence of a palpable mass.
- Patients with nipple discharge and no palpable findings require regular follow-up.
- Early detection and appropriate diagnostic procedures are vital for managing breast conditions presenting with nipple discharge.