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

Patients with serous or bloody nipple discharge arising from a single duct are treated by a joint radiological/surgical approach at our institution. Two galactograms are performed; the first with contrast medium alone to identify any lesion and the second, one hour prior to surgery, using both contrast and methylene blue. This defines the area for the surgeon ensuring the involved duct is removed. Several case histories are described and the galactographic technique is detailed.
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PMID:Galactography with contrast and dye--a two stage radiological/surgical approach to serous or bloody nipple discharge. 260 37

One hundred thirty-one fine-needle aspirations and 85 nipple discharge smears were evaluated cytologically and correlated with histological diagnoses and with clinical impressions. This study demonstrates that cytological diagnosis of breast lesions is a useful and clinically accurate procedure.
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PMID:Cytological diagnosis of breast cancer. 260 7

We have previously reported carcinoembryonic antigen (CEA) measurement in nipple discharge to be a useful adjunct in the diagnosis of non-palpable breast cancer. As an extension, a dot-immunobinding assay was developed to screen a large number of patients with nipple discharge for non-palpable breast cancer. The principle is as follows. CEA bound to a solid phase monoclonal anti-CEA antibody is detected by a second monoclonal anti-CEA antibody conjugated with horseradish peroxidase. The use of tetramethylbenzidine as a chromogen results in a stable color reaction that can be semiquantitively analyzed by the naked eye. The CEA levels determined by this dot assay correlated well with CEA levels determined using the former Elmotec assay. To determine whether or not the method could also be feasible in the detection of non-palpable breast cancer, a collaborative study from 12 Japanese institutes was organized. The CEA levels in nipple discharges from 155 patients were assayed. Thirteen of 30 patients with palpable breast cancer and 22 of 30 patients with non-palpable breast cancer exhibited CEA values higher than 400 ng/ml, a cut-off value determined using 89 benign controls. The specificity (91%) and sensitivity (73%) of this test were higher than those of mammography or cytology. The incidence of elevated CEA levels in nipple discharge correlated significantly with the incidence of intratumoral antigen expression. Thus, the system could prove useful in screening for early breast cancer.
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PMID:Evaluation of dot-immunobinding assay for carcinoembryonic antigen determination in nipple discharge as an adjunct in the diagnosis of early breast cancer. Research Group for Carcinoembryonic Antigen in Nipple Discharge. 269 32

Periductal mastitis/duct ectasia affects major breast ducts and is poorly understood. A variety of different terms have been used for this condition and these probably reflect different stages in one disease process. It appears to be responsible for 1-2% of all symptomatic breast conditions. Although the incidence is higher in postmortem studies, much of what is included as so-called "periductal mastitis" or "duct ectasia" in these studies is duct dilatation, which occurs as part of normal breast involution. Periductal mastitis appears to be the primary condition with duct ectasia being the outcome. The cause of this periductal mastitis is uncertain, although bacteria, particularly anaerobic organisms, appear to play some role. Clinically, this condition can present with noncyclical mastalgia, nipple discharge, nipple retraction, a subareolar breast mass with or without overlying breast inflammation, a periareolar abscess, or a mammillary fistula. Antibiotics effective against the organisms isolated from this condition are effective in resolving periareolar inflammation and are useful when combined with surgery in mammillary fistula.
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PMID:Periductal mastitis/duct ectasia. 269 25

In a series of 8,703 breast operations, nipple discharge was the presenting symptom in 7.4% of cases. It is even more common in the office and clinic since many discharges can be treated medically. To be significant, a discharge should be true, spontaneous, persistent, and nonlactational. Of the 7 basic types, i.e., milky, multicolored and sticky, purulent, clear (watery), yellow (serous), pink (serosanguineous), and bloody (sanguineous), the last 4 are the surgically significant ones. Of the 586 patients operated on for one of these types of discharge, the majority had a benign etiology, i.e., intraductal papillomata (48.1%) and fibrocystic changes (32.9%), but 14.3% were due to cancer and another 7.3% to precancerous mastopathy. In the 84 patients with cancers, the false-negative rate for mammography was 9.5% and was 17.8% for cytology. There was no palpable mass in 13.1% of patients. There was an increasing likelihood of the discharge being due to cancer when the discharge was, in order of increasing frequency, yellow, pink, bloody, or watery, when it was accompanied by a lump, when it was unilateral and from a single duct, when the mammogram or galactogram and the cytology were positive, and when the patient was over 50 years of age. Milky discharges are usually treated medically unless they are due to a pituitary adenoma. If the cause cannot be found and eradicated, bromocriptine is the drug of choice. Multicolored sticky discharges are also treated medically, chiefly by nipple hygiene, except when advanced. Purulent discharges are treated with appropriate antibiotics but abscesses need drainage and a biopsy of the wall. Except in women under 35 years of age or in those anxious to have children, surgically significant discharges are treated by central duct excision. Good cosmetic results can be obtained with careful technique and the danger of a recurrent discharge is eliminated.
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PMID:Management of nipple discharge. 269 28

A follow-up study of 105 patients with microdochectomy for nipple discharge during the ten year period from 1965 to 1974 revealed that cancer developed in seven of the cases. The histology of the seven cases consisted of atypical hyperplasia in the terminal duct or lobular neoplasia. Accordingly, patients with either of the above histological findings were regarded as high risks for the development of breast cancer. Twenty such high risk patients were selected from 1850 patients biopsied for benign breast disease during the eleven year period from 1975 to 1985. This follow-up study revealed that five of the 13 patients (38%) with atypical hyperplasia in the terminal duct and two of the seven patients (28%) with lobular neoplasia developed breast cancer. Microphotocytometry using TV image analyzed system showed that the mean +/- standard deviation of the nuclear area and the absorbance were, respectively, 46.79 +/- 2.84 and 0.42 +/- 0.01 in fibroadenoma, 62.93 +/- 12.15 and 0.32 +/- 0.02 in precancerous lesion and 86.16 +/- 14.38 and 0.44 +/- 0.07 in breast cancer.
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PMID:[Follow-up study of precancerous lesions of the breast]. 273 58

In a series of 12 patients with bloody nipple discharge, a new technique of mammary ductal localization was used to identify the duct responsible for the discharge and assure its complete removal for pathological diagnosis. This procedure utilizes a 30-gauge anterior chamber needle that is gently advanced into the offending duct, and methylene blue dye is injected to outline the involved duct for easy dissection though a circumareolar incision. This provides the pathologist with an intact specimen and avoids the problems associated with specimen roentgenography or loss of a ductal probe during the procedure. Because we feel that all patients with a bloody nipple discharge warrant a biopsy, this procedure provides a safe, rapid, effective method and allows the biopsy to be done on an outpatient basis.
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PMID:A new surgical localization technique for biopsy in patients with nipple discharge. 274 93

The authors report their experience in the galactographic study of 95 women with nipple discharge; 65 of them previously underwent both surgical and histological control. The galactographic features are classified according to predominant alterations: ductal ectasia, ductal stenosis, ductal amputation, solitary/multiple filling defects, ductal dystrophy, and irregular distribution of ductal branches. Histopathological findings (65 patients) appear to be related to nipple discharge types: thus, hematic secretion results pathognomonic for intracanalicular neoplasm (24/25), while serous and serous-hematic discharge (32/65) may be caused by any mammary pathologies. Galactography is therefore recommended, being sometimes the only reliable diagnostic method and allowing both topography and extension of the lesion to be demonstrated, which are necessary elements for planning adequate surgical treatment.
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PMID:[Galactographic features of the secreting breast]. 275 82

Breast ductography is a safe and simple technique to outline the duct system of the breast with contrast medium in patients with nipple discharge. The results of 60 successful ductograms are presented and an assessment of its clinical usefulness is made.
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PMID:Breast ductography--its role in the diagnosis of breast disease. 279 72

A rare case of a non-invasive carcinoma of the breast is reported. A 39-year-old woman was admitted to our hospital complaining of large breast lump (11.5 X 8.0 cm) and an abnormal nipple discharge. Mammography revealed widely dispersed microcalcifications and an echographic diagnosis indicated a fibrocystic disease. A cytologic examination of the nipple discharge showed malignant cells with a CEA level that was very high. The patient was treated with a standard radical mastectomy. Specimen mammography showed microcalcification in almost all sections. The histological examination, using serial sections, was seen to be consistent with a non-invasive ductal carcinoma. No lymph node or remote distant metastasis was found.
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PMID:[A case of a non-invasive carcinoma of the breast with unusual clinicopathological appearance]. 282 78


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