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Clinical Significance of Pathological Nipple Discharge as a Single Breast Symptom: A Single-institute Experience

Mostafa Ramadan and Rabie Ramadan

Journal Title:Acta Scientific Women's Health
Abstract


Background: Nipple discharge is a common symptom which can cause anxiety although usually caused by benign etiologies and only reported as the presenting symptom in 15% of breast cancer cases. The evaluation and management of nipple discharge is diverse and confusing between breast clinics. The aim of this study was to identify clinical characteristics and preoperative examinations which can be used to identify malignancy as the underlying cause of nipple discharge, thereby facilitating patient tailored treatment.Patients and Methods: We retrospectively reviewed all patients with nipple discharge as a single symptom who attended our insti-tution breast clinic from March 2018 till February 2020. Patients clinical, radiological, lab, pathological, surgical and follow up data were registered. Results:A total of148 patients with nipple discharge were reviewed. Discharge was unilateral in 70.3%, Multiductal in 58.1%, bloody in 23% and induced on squeezing in 62.2% of the included patients. the causes of discharge were ductectasia in 47 patients (51.6%), benign papilloma in 28 patients (30.8%) and carcinoma in 12 patients (13.2%){DCIS in 7 patients (7.7%) and IDC in 5 patients (5.5%)}. Regarding discharge characteristics in cancer patients; it was unilateral (58.3%), uniductal (66.7%), bloody (75%) and induced (75%).Conclusion:Pathological nipple discharge is a common breast complain and may indicate serious condition. Although unilateral, uniductal, bloody and induced discharge in patients above 50 years old with abnormal imaging and suspicious pathology are alarm-ing signs of malignancy; non-bloody, bilateral, multiducatl and spontaneous discharge with normal imaging and non-suspicious pa-thology may still carry the risk of underlying malignancy.

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