Surgical management of pathologic nipple discharge
- Roshni Rao, MD
Roshni Rao, MD
- Section Editor
- Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
- Section Editor — Breast Surgery
- Associate Professor, Department of Surgery
- Yale University School of Medicine
Nipple discharge is the third most common breast-related complaint, after breast pain and breast mass. Nipple discharge is categorized as normal milk production (lactation), physiologic nipple discharge, or pathologic (suspicious) nipple discharge. The most common causes of pathologic nipple discharge are benign intraductal papilloma (48 percent), ductal ectasia (15 to 20 percent), and carcinoma (10 to 15 percent) .
Surgical management of pathologic nipple discharge is discussed here. Other aspects of nipple discharge are discussed elsewhere. (See "Nipple discharge".)
DEFINITION OF PATHOLOGIC NIPPLE DISCHARGE
Pathologic nipple discharge is defined by the presence of one or more of the following:
●Unilateral nipple discharge
●Bloody nipple discharge
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- DEFINITION OF PATHOLOGIC NIPPLE DISCHARGE
- INITIAL APPROACH TO PATHOLOGIC NIPPLE DISCHARGE
- Palpable breast mass
- No palpable breast mass
- - Abnormal ultrasound or mammogram
- - Normal ultrasound and mammogram
- Unilateral discharge (bloody or nonbloody)
- - Galactography
- - Ductoscopy
- Bilateral bloody discharge
- PREOPERATIVE PREPARATION
- Surgical anatomy
- Anesthesia considerations
- SURGICAL TECHNIQUES
- Lesion not localized: complete subareolar duct excision
- Lesion localized: microductectomy
- POSTOPERATIVE CARE
- FOLLOW-UP CARE
- SUMMARY AND RECOMMENDATIONS