T Richards1, A Hunt, S Courtney, H Umeh. 1. Department of Surgery, Royal Berkshire Hospital, Reading, UK. tobyrichards@btinternet.com
Abstract
INTRODUCTION: Nipple discharge is regarded a sign of breast cancer. Type of discharge and cytology are unreliable for diagnosis. Most malignant cases have a detectable breast mass. The aim of this study was to assess the association between nipple discharge and breast cancer. PATIENTS AND METHODS: Patients who underwent operation for nipple discharge at a district general hospital (population 460,000) over a 3-year period were included. All had normal clinical, radiological and cytological examination. Operation and histopathology reports were reviewed. RESULTS: Eighty-six patients underwent operation for nipple discharge. Median age was 54 years (range, 32-84 years). Analysis of nipple discharge revealed red blood cells (RBCs) in 35 patients (40%). At operation, 81 patients underwent radical sub-areola duct excision (Hadfield's procedure) and five microdochectomy. Histopathology reported duct ectasia in 59 patients and benign ductal papilloma in 25. Two patients had occult malignancy - DCIS (1) and LCIS (1). No invasive cancer was found. CONCLUSIONS: Nipple discharge alone is not usually a sign of breast cancer. Occult malignancy is rare. A period of 'watchful waiting' may prevent patients undergoing unnecessary surgery.
INTRODUCTION: Nipple discharge is regarded a sign of breast cancer. Type of discharge and cytology are unreliable for diagnosis. Most malignant cases have a detectable breast mass. The aim of this study was to assess the association between nipple discharge and breast cancer. PATIENTS AND METHODS: Patients who underwent operation for nipple discharge at a district general hospital (population 460,000) over a 3-year period were included. All had normal clinical, radiological and cytological examination. Operation and histopathology reports were reviewed. RESULTS: Eighty-six patients underwent operation for nipple discharge. Median age was 54 years (range, 32-84 years). Analysis of nipple discharge revealed red blood cells (RBCs) in 35 patients (40%). At operation, 81 patients underwent radical sub-areola duct excision (Hadfield's procedure) and five microdochectomy. Histopathology reported duct ectasia in 59 patients and benign ductal papilloma in 25. Two patients had occult malignancy - DCIS (1) and LCIS (1). No invasive cancer was found. CONCLUSIONS: Nipple discharge alone is not usually a sign of breast cancer. Occult malignancy is rare. A period of 'watchful waiting' may prevent patients undergoing unnecessary surgery.
Authors: J A van Dongen; I S Fentiman; J R Harris; R Holland; J L Peterse; B Salvadori; H J Stewart Journal: Lancet Date: 1989-07-01 Impact factor: 79.321
Authors: Nour Alshurbasi; Christopher W J Cartlidge; Stanley R Kohlhardt; Sirwan M Hadad Journal: Breast Care (Basel) Date: 2019-12-13 Impact factor: 2.860