Management of Nipple Discharge: Our experience

Abstract

Introduction: Nipple discharge continues to be a bothersome complaint by the patients. Nipple discharge is associated with non malignant causes as well and needs proper evaluation and treatment. We conducted a study in our departement to analyse the various management options for patients suffering from various types of nipple discharge.

Patients and methods: Patients presenting with complaints of nipple discharge, either spontaneous or non spontaneous in the age group of 15-55 years were included in the study. Patients with  breast cancer , lump or abscess were excluded.

Results: A total of 66 patients with mean age of 39 were selected for analysis. Mean age of the patient was 39 years. 32  patients (48.4%) had greenish discharge, 16  (24.4 %)  had bloody discharge, 12 (18.2%)had clear discharge and 6  (9.09%) had milky discharge. Cytology and Imaging of the patients were done according to the age of the patient. of discharging fluid was done in all cases which revealed epithelial cells in 38 (%), duct papilloma in 16 (24.4), histiocytes in 10 (15.1%) and atypical cells in 2 (3.03%) patients. Ultrasonography of the breast was done in 36 (54.5%), X ray mammography in 30 (45.5%) patients. A total of 27 (40.9%) patients underwent surgery, of whom 12 (18.2%) were subjected to microdochotomy and 15 (22.7%) to hadfield’s operation. The  histopathology of the resected specimen revealed duct papilloma in 16 (24.4%) patients, duct ectasia in 10 (15.1%) and ductal carcinoma in situ in 1 (1.1%) patient.

Conclusion: Management of nipple discharge is complex and involves multi disciplinary approach. Majority of patients can be managed  conservatively, however a significant number of patients need surgical treatment as well.