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

Between 1981-88, 223 surgical interventions were performed in cases of pathologic breast secretion after exclusion of extra-mammary aetiology. The milk duct was identified by pre-operative chromogalactography, followed by a selective excision of the ductal-lobular unit. In 36 cases (16.1%), however, neither spontaneous nor provocable secretion remained after diagnostic galactography, so that a segment resection was required. In all tissue specimens, the cause of the pathologic secretion was found histologically; most often, it was fibrocystic disease or solitary intraductal papilloma (21.5% each). In 32.3% of the specimens, findings with a prospective significance (papillomatosis, carcinoma in situ or invasive carcinoma) were discovered and further operative treatment was initiated. The colour of the discharge allowed no prediction of the histological findings. In 28.6% (8/28) of the carcinomas, secretion was bilateral. In 46.4% of the specimens containing carcinoma, papillomatosis was also detected; vice versa, papillomatosis was associated with carcinoma in 22.8%. The recurrence rate of 1.6% indicates the efficiency of this method in removing the pathology. The diagnostic value of galactography for the prediction of findings with a prospective significance was considerably reduced by a rate of 37.5% false-negatives; therefore, we have decided to omit diagnostic galactography in our patients. Now, provided extra-mammary causes of the nipple discharge have been excluded and mammography has been inconspicuous, a selective excision of the ductal-lobular unit is performed after preoperative chromogalactography.
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PMID:Chromogalactography preceding ductal-lobular unit excision for nipple discharge--with special reference to diagnostic galactography and histology. 235 57

Six hundred sixty-nine breast biopsies performed at the Methodist Hospital of Southern California and the Arcadia Outpatient Surgery Center during 1987 and 1988 were reviewed. Three hundred twenty-eight biopsies were performed for clinical indications (lump, thickening, or nipple discharge). Three hundred forty-one biopsies (51%) were performed because of mammographic abnormalities and required preoperative x-ray localization. Of the 341 localized biopsy specimens, 261 were varieties of fibrocystic mastopathy, fibroadenoma, papilloma, or hyperplasia. An additional 31 cases showed atypical ductal or lobular hyperplasia. One hundred fifty-one breast cancers were detected in this series of 669 breast biopsies. One hundred two (68%) of these were detected as a result of a clinical finding, and 49 were detected as a result of mammographic abnormalities (a 32% incidence of occult breast cancers). Among the 341 x-ray localization biopsies performed, breast cancer was detected in 14%.
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PMID:Breast cancer detection: experience in a suburban community. 236 May 71

We describe the clinical and mammographic signs observed in 20 patients with atypical hyperplasia of the breast. The clinical signs include abnormalities noted at palpation (tumefaction, masses, clusters of nodules) and nipple discharge. The mammographic signs include rounded, clearly delineated opacities with benign appearances, or spiculated masses possibly associated with microcalcifications, stellate opacities, and isolated foci of microcalcifications. Galactography may visualize milk ducts dilatation. Both the clinical and mammographic signs are non-specific and even equivocal and do not allow pre-operative diagnosis of non-specific lesions.
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PMID:[Borderline lesions of the breast: clinical and radiological study of 20 cases]. 236 63

Nipple discharge, a rare clinical sign, is more frequently determined by benign breast diseases, but it can be associated to breast cancer; for this reason such clinical sign shouldn't be ignored. Cytologic examination together with breast examination and thermography are the correct oncologic approach for nipple discharge, because such way it is possible to select the patients for whom mammography or galactography are recommended as well as and breast biopsy depending on the galactographic data.
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PMID:[Breast secretions]. 251 53

This is a statistical analysis of the use of mammography in the symptomatic patient. Eighty-eight percent of women older than 50 years who had a palpable cancer of the breast had a positive mammogram; only 57% of women younger than 51 years of age had a positive mammogram. When the cancer presented as nipple discharge or Paget's disease without a mass, mammography was of no help in determining the need for surgery. One synchronous cancer per 100 patients, in the contralateral breast, was detected by mammography only. Eleven percent of the patients, who had a previous cancer of the breast and were followed for a maximum 11 years, developed cancer of the contralateral breast; 50% of the metachronous cancers were found by mammography only. In 1000 symptomatic patients without an indication for biopsy on physical examination, five cancers were found on mammography. Mammography uncommonly demonstrates unsuspected cancer in the symptomatic patient. Its greatest value is in finding metachronous cancers.
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PMID:Mammography in the symptomatic woman. 253 80

Seven cases of carcinoma of male breast were reported. The mean age of them was about 65 years, 17 years older than that of female breast cancer. Six tumors out of 7 were located under the areola. By histological examination, 4 of 7 cases were proved to be noninvasive ductal carcinoma, and the others are invasive ductal carcinoma (2 : scirrhous, 1 : solid-tubular). We focused on clinicopathological features of noninvasive carcinoma. There were two points to be mentioned. One is the nipple discharge as a chief complaint, and the other is cyst formation as a macroscopic observation. These features are characteristic to noninvasive carcinoma and contribute to diagnosis. Therefore, for screening the mass of male breast, ultrasonography (U.S.) is most useful. For preoperative final diagnosis, aspiration or smear cytology is essential. In regard to postoperative survival, all of the 3 invasive cases were dead but all of the 4 noninvasive cases are alive. So the prognosis of noninvasive carcinoma of male breast does not appear to be worse than the female one. These observations indicate that the prognosis of carcinoma of male breast can be improved by early diagnosis and appropriate surgical therapy.
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PMID:[Carcinoma of male breast--with special reference to noninvasive carcinoma]. 254 34

The term ductal adenoma has been recently introduced to describe a solid benign lesion of breast ducts. This study describes the clinical, morphologic, and immunohistochemical features of 15 cases of ductal adenoma. Ductal adenomas are usually single, occasionally multiple, lesions occupying medium- and large-sized breast ducts. They may occur in women of all ages, although the majority of patients are 60 years of age or greater. Ductal adenomas usually present clinically as breast lumps which may mimic carcinoma; less commonly, they are associated with nipple discharge. Patients in this series showed no family or previous history of breast disease and had uneventful follow-up after local excision. Despite often showing worrying pseudoinfiltration and cytologic atypia, the immunohistochemical demonstration of a myoepithelial layer and intact basement membrane around the tubules was clear evidence of the benign nature of the lesions. We conclude that most ductal adenomas evolve by sclerosis of benign intraduct papillary lesions, although processes similar to sclerosing adenosis and, possibly, duct ectasia may contribute to the pathogenesis of a proportion of cases. It is hoped that a wider appreciation of the entity of ductal adenoma will reduce the diagnostic uncertainty that continues to surround these and related lesions.
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PMID:Ductal adenoma of the breast--a review of fifteen cases. 255 Mar 51

Two cases of noninvasive ductal carcinoma detected by galactography are reported with reference to our diagnostic methods of a patient with nipple discharge. Abnormal nipple discharge with no demonstrable breast lump is rare but an important clinical sign, since it is sometimes produced by malignant lesions. Non-contrast mammography and cytologic examination is of limited diagnostic value for abnormal nipple discharge. Galactography is necessary for the detection of ductal carcinoma in early stage. The most important factor in improving the survival statistics for breast carcinoma is early detection.
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PMID:Usefulness of galactography for minimal noninvasive ductal carcinoma of the breast. 255 51

Aspiration specimens from 12 patients with histologically documented ductal carcinoma-in-situ (DCIS) of the breast (seven patients) or DCIS with minute foci of stromal invasion (five) were evaluated. Five patients presented with palpable masses, 1.5-4.0 cm, and four patients presented with localized thickening, associated with nipple erosion and discharge in two of them. One patient had nipple inversion, and one patient had bilateral nipple discharge. In one patient, no apparent abnormality of the breast was present. Mammography was either suspicious for or strongly suggestive of carcinoma in 10 patients and negative in two. Aspirates from all patients were composed of fragments of atypical ductal epithelium and numerous single epithelial cells. In nine cases, the smears were hypercellular and similar to aspirates of typical invasive ductal carcinoma. Calcifications were present in six cases. In four of these, associated tumor necrosis was evident. Cytologic features separating DCIS patients from those showing minimal stromal invasion or common types of invasive ductal carcinoma (IDC) were not identified. We conclude that fine-needle aspiration cytology of DCIS is identical to that of IDC. If preoperative radiotherapy or chemotherapy is considered in the management of invasive breast carcinoma, cutting-needle biopsy for confirmation of tumor invasion is necessary.
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PMID:Ductal carcinoma-in-situ of the breast: fine-needle aspiration cytology of 12 cases. 255 63

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


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