Breast: Nipple Discharge

Published on 06/06/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 06/06/2015

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Chapter 154 Breast: Nipple Discharge

INTRODUCTION

Description: Nipple discharge is a distressing symptom that accounts for roughly 5% of breast complaints.
Prevalence: Three percent to five percent of breast problems, 5% of women who are not lactating, >50% of women can express secretions.
Predominant Age: Reproductive (based on pathophysiologic changes).
Genetics: No genetic pattern.

ETIOLOGY AND PATHOGENESIS

Causes: Based on underlying pathophysiologic changes.
Risk Factors: See individual pathologic conditions.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Spontaneous, continuous, or intermittent release of fluid from one or both breasts that may be milky, bloody, serous, serosanguineous, or cloudy; most physiologic discharge is white or green, clear, or yellow; serosanguineous or bloody nipple discharge is associated with malignancy in 7% to 17% of cases, but the color or clarity of the fluid cannot diagnose or rule out carcinoma.

DIAGNOSTIC APPROACH

Differential Diagnosis

• Breast cancer
• Intraductal papilloma
• Galactocele
• Ductal ectasia (associated with burning, itching, or local discomfort in older patients)
• Fibrocystic change
• Mastitis

Associated Conditions: Fibrocystic change, fibroadenoma.

Workup and Evaluation

Laboratory:

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