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Query: UMLS:C0149741 (nipple discharge)
 551 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pathologic diagnosis of 282 consecutive breast lesions seen in 255 black patients over a 3-year period (January 1975-December 1977) at Harlem Hospital Center were reviewed and analyzed. The most common lesion was fibroadenoma, accounting for 34.7% of all lesions and 48% of benign breast lesions, followed by carcinoma (28%) and fibrocystic disease (17%). Other major benign breast lesions in order of frequency were intraductal papilloma, sclerosing adenosis, chronic mastitis, and fat necrosis. One each of the following rare lesions was observed: papillomatosis, ducatal ectasia, cystosarcoma phylloides, and granular cell tumor. Multiple lesions were found in 1 or both breasts in 15% of all benign breast disease cases, with fibroadenoma being the most common lesion. 94% of the patients presented with a breast mass, 5% with nipple discharge, 5% with pain, and 2% with a history of trauma to the breast. The lesions varied in size from 0.5-10 cm, and had been present for a few days to 20 years before medical treatment was sought. The upper quadrant of the breast was the most common site for lesions. Peak age incidence for all benign breast lesions was 20-35 years; for fibroadenoma, peak age incidence was 16-25 years and for fibrocystic disease, 40-50 years. The surgical literature shows that in a predominantly white population, peak age of incidence for benign lesions is 30-49 years; this disparity in age distribution may be due to the high percentage of adolescent patients with fibroadenoma in the Harlem Hospital series. Median age of patients with breast carcinoma in this series is 61 years. 24 patients (13.7%) with benign breast disease had taken oral contraceptives before the breast biopsies were performed. However, the study population is to small and follow-up time to short to draw any conclusion regarding the relation of oral contraceptive use to the subsequent development of breast cancer. This study shows that compared to the white population, fibroadenoma is more frequent than cancer in black women while cancer is more frequent than fibroadenoma in white women.
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PMID:Analysis of benign breast lesions in blacks. 45 72

A review of the histories of 1059 patients with breast problems seen consecutively in office consultation revealed an incidence of breast cancer of 13%. Patients over 50 years of age or whose mother or sister had had breast cancer had a substantially greater likelihood of having breast cancer. The finding of the problem on routine examination, a family history of breast cancer in a relative other than the mother or a sister, or prominent breast pain or nipple discharge made the diagnosis of cancer less likely. Menstrual status, a history of previous benign disease, nulliparity, current hormone therapy and duration of symptoms did not help identify the patient likely to have breast cancer. Much time could be saved for both doctor and patient in taking the history from patients with breast disorders. Only the patient's age and the history of the mother and sisters with regard to breast cancer will help identify the "high-risk" patient. Other historical findings are either valueless or should be used to reassure these usually anxious women.
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PMID:Value of the history in the office diagnosis of breast cancer. 86 61

A review is presented of 2,000 consecutive new, patients with breast complaints. Emphasis is placed on the specific complaint as correlated with patient age and the incidence of breast cancer. The initial complaints were a lump (50%), an abnormal mammogram (32%), other complaints (8%), breast pain (6%), and nipple discharge (4%). Follow-up information was available for 1,889 patients. The majority of the patients (68%) were under 50 years of age. Of 831 patients to whom a biopsy was recommended, 720 ultimately had a biopsy and 147 cancers were identified. Sixty-five per cent of the cancers were in women aged 50 years or greater. Of the patients aged 50 years or older, 16.1 per cent had breast cancer, while only 4.0 per cent of the patients less than 50 years and 0.8 per cent of the patients less than 30 years of age had breast cancer. The author concludes that the overwhelming majority of patients (92%) referred to a breast surgery practice do not have malignancy. Thus, primary physicians undoubtedly see even a smaller per cent of breast complaints ultimately result in the diagnosis of breast cancer. There is a need to better inform the public as to the significance of breast complaints and to establish more specific criteria for biopsy, particularly in the young, professional, liability threats not withstanding.
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PMID:The significance of breast complaints as correlated with age and breast cancer. 161 86

The Norplant System consists of 6 capsules each containing 36 mg of crystal line levonorgestrel (LNG), for a total dose of 216 mg LNG. The capsules are inserted subdermally in the mid-upper arm, and LNG diffuses continuously through the capsule walls for 5 years. In the United States the Norplant System was approved in December 1990. The initial rate of hormone delivery is about 85 mcg/day, then decreases over the next 9 months to 5 mcg/day, and over the ensuing 9 months to 35 mcg/day. Thereafter, the diffusion rate levels off for the next 3.5 years, averaging around 30-35 mcg/day. Removal results in a drop in the plasma concentration of levonorgestrel to below contraceptive levels within 24 hours and below the detectable limit of .1 pg/ml at 96 hours. Preliminarily data from 402 users over 5 years show improvements of Norplant produced better efficacy in all weight classes and a lowered cumulative rate of 1.1 pregnancies of 100 users. The pregnancy rate for the first year of use is 02., better than for oral contraceptives. Side effects include headache, nervousness, nausea, dizziness, dermatitis, acne, change of appetite, breast tenderness, minimal weight gain, some change in hair distribution, and adnexal enlargement. Adverse reactions include breast discharge, possible cervicitis, musculoskeletal pain, abdominal discomfort, leukorrhea, and vaginitis. More than the usual number of bleeding days occurred in slightly more than one fourth of the patients, prolonged bleeding in 27.6% spotting in 17.1% and amenorrhea in 9.4% of patients. Hyperlipidemic users should be observed for possible low-density lipoprotein elevations. The cumulative discontinuation rate for pregnancy was 3.9 per 100 users; for bleeding irregularities the rate was 25.1 per 100 users, and for other medical results it was about 22.4 per 100 users. Personal reasons for discontinuation accounted for 38.7 per 100 users, equivalent to a cumulative continuation rate of about 30 per 100 users over the 5-year duration.
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PMID:The NORPLANT system of contraception. 168 4

Of the three commonest symptoms found in 3294 patients referred to a specialty breast clinic--mass, nodularity and pain--only nodularity was age related. Only 30% of the patients had a clinically localized abnormality, and only 19% of these abnormalities were suggestive of carcinoma. The majority of suggestive lesions were in women over 55 years of age. Of the patients seen because of a breast lump, 46% were found to have a significant mass. Most abnormalities were found in patients presenting with a mass or nipple discharge, and the significance was age related. Symptoms associated with the lowest rate of positive biopsies were nodularity, pain and skin or nipple changes. The biopsy and cancer rates were significantly age related. The cancer rate in women 40 years of age and under was 0.8%, between 41 and 55 the rate was 5%, and in those over 55 it was 21%. The predominant finding in young women was a fibroadenoma. In the middle age range fibrocystic change was most common, and in postmenopausal women most of the lesions were malignant.
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PMID:Age-related breast diagnosis. 173 90

Experience with magnetic resonance imaging (MRI) of the breast remains limited. MRI studies to date have shown that differentiation of carcinoma from certain benign breast changes can be difficult. The problem of suspected tumour recurrence in patients with known but treated breast carcinoma is considered. Forty-five patients were studied, all having been treated by lumpectomy combined with radiotherapy and/or chemotherapy. Suspicion of recurrence was suggested by X-ray mammography or clinically by the presence of a current breast mass, breast pain, or nipple discharge. The principle differential diagnosis rested between post-treatment fibrosis and recurrent tumour. Axial and sagittal images were obtained using T1-and T2-weighted pulse sequence. Images were enhanced with intravenous gadolinium DTPA in cases where there was a mass. The tomographic format and inherent high soft tissue contrast provided by MRI are of particular value in this situation. The morphological appearances of recurrent tumour, fibrosis, and other post-radiation affects are described and compared. MRI allowed accurate differentiation in the majority of case. In equivocal cases enhancement of mass lesions with gadolinium DTPA provided excellent confirmatory evidence of recurrent tumour.
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PMID:The role of magnetic resonance imaging in the assessment of local recurrent breast carcinoma. 184 73

Certified nurse-midwives provide primary care for women. An essential part of a physical examination is a complete assessment of the breasts. Normal breasts and their variations and deviations are discussed, with particular attention paid to breast pain, masses, and nipple discharge, and the clinical implications of each. In addition, the demographics, risk factors, staging criteria, and treatment modalities of breast cancer are presented.
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PMID:Breast disease. The role of the nurse-midwife. 200 96

To assess the morbidity associated with false alarms of breast cancer, 2923 consecutive consultations for a breast disorder were reviewed. 391 women had breast cancer, which was found by accidental discovery in 57%, by breast self-examination in 15%, by routine physical examination in 24%, and by screening mammography in 4%. 20% of women in whom cancers were found by physician screening had had a previous breast cancer. The pathological stages of tumours found by accident were little different from those found by intervention. 87% (2532/2923) of signs/symptoms of breast cancer were false alarms--ie, 86% (565/659) of those found by routine physical examination, 88% (406/462) breast self-examination, 93% (220/237) screening mammography, and 86% (1341/1565) accidental discovery. Spontaneous breast pain was responsible for 575 false alarms and nipple discharge for 126. 534 (20%) of the false alarms could have been avoided if routine physical examinations before the age of 45, breast self-examination before the age of 35, and screening mammography before the age of 60 had been discouraged. Another 30% of false alarms would have been avoided if the patient had realised that breast pain and nipple discharge are not usually symptoms of breast cancer.
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PMID:False alarms of breast cancer. 196 61

The most common breast complaints are nipple discharge, breast pain and a breast mass. These problems can be evaluated in a step-wise manner to determine whether the etiology is cancer. A breast mass is the most common symptom of cancer, but breast pain and nipple discharge also must be evaluated carefully. The history and physical examination, needle aspiration, mammography, ultrasound examination and biopsy are useful in determining the underlying cause of the problem.
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PMID:Evaluation of a breast complaint: is it cancer? 830 65

Breast health means more than breast cancer. At least 50% of patients seen at a multidisciplinary breast center have benign conditions. Pain, nipple discharge, and a question of a mass are the usual chief complaints. This article provides contemporary information and management guidelines for the common breast conditions associated with these complaints.
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PMID:Controversies in benign breast disease. 953 77


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