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Query: UMLS:C0849787 (nipple discharge)
 518 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It is almost impossible to diagnose early cancers by elevated tumor markers in serum. However, it is possible by detecting tumor associated biomarkers in the excreted specimens such as nipple discharge, urine and feces. Elevated CEA in nipple discharge is indicative of non-palpable "To" early breast cancer, elevated fecal CEA indicated hemoccult test-negative colon cancer, basic fetoprotein and beta-hCG core fragment in the urine for urogenital malignancies, and urinary VMA or HVA for asymptomatic neuroblastomas. Detection of abnormal genes is more sensitive than cytology and suggests cancers or precancerous changes. PCR-SSCP method enabled to determine Ki-ras gene mutation in pancreatic juice and in duodenal juice in pancreatic cancer patients.
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PMID:[Tumor associated biomarker for early diagnosis of cancer]. 896 52

From 1970 to 1992, 31 pure ductal carcinoma in situ (DCIS) of the male breast treated in 19 French Regional Cancer Centres were reviewed. They represent 5% of all breast cancers treated in men in the same period. The median age was 58 years, but 6 patients were younger than 40 years. TNM classification (UICC, 1978) showed 12 T0 (discovered only by bloody nipple discharge), 10 T1, 5 T2 and four unclassified tumours (Tx). 11 patients (35.5%) had clinical gynecomastia, and three (10%) had a family history of breast cancer. 6 patients underwent lumpectomy, and 25 mastectomy. Axillary dissection was performed in 19 cases. 6 cases received postoperative irradiation. 15 out of 31 lesions were of the papillary subtype, pure or associated with a cribriform component. The size of the 12 measured lesions varied from 3 to 45 mm. All lymph nodes sampled were negative. With a median follow-up of 83 months, 4 patients (13%) presented a local relapse (LR), respectively, at 12, 27, 36 and 55 months. 3 of these patients had been initially treated by lumpectomy. In one case LR was still in situ, but already infiltrating in the 3 others. Radical salvage surgery was performed in 3 cases, but one patient developed metastases and died 30 months later. The last patient was treated by multiple local excisions and tamoxifen. One 43-year-old patient developed a contralateral DCIS and three others developed a metachronous cancer. The aetiology and risk factors of male breast cancer remain unknown. Gynecomastia, which implies an imbalance between androgen and oestrogen, may be a predisposing factor. As in women, DCIS in the male breast has a good prognosis. Total mastectomy without axillary dissection is the basic treatment. Frequently, the first symptom is a bloody nipple discharge. The age of occurrence is younger than for infiltrating carcinoma, suggesting that DCIS is the first step in the development of breast cancer.
Eur J Cancer 1997 Jan
PMID:Ductal carcinoma in situ of the male breast. Analysis of 31 cases. 907 92

Breast cancer is one of the most dreaded diseases affecting women and is associated with a high degree of morbidity and mortality. Any breast complaint has the potential for creating a great deal of anxiety for patients and providers alike. An in-depth understanding of the pathophysiology of common breast complaints, particularly those with low probability of association with cancer such as nipple discharge, can serve to allay anxiety and prevent the financial and emotional burden of unnecessary diagnostic evaluations. It will then improve the quality of care for each patient experiencing the symptom. Although the greatest incidence of nipple discharge is not secondary to malignant processes, the fact that some are requires that all persons with nipple discharge receive the benefit of a thorough assessment. When planning a course of action to assess and treat nipple discharge, a thoughtful stepwise, planned approach is necessary. The evaluation of nipple discharge can be undertaken with minimal difficulty by performing a thorough history, a careful physical examination, and following a logical thought process in linking the type of discharge with the suitable adjunct diagnostic testing. Appropriate management evolves from this process. It is important to view the patient in total, considering such issues as family history, other risk factors, how disruptive the level of anxiety about the symptom. Primary care providers, working with their parents, are well positioned to design appropriate diagnostic and treatment regimes to assess and treat nipple discharge. A thoughtful, prudent approach to this symptom can save both health care dollars and lives.
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PMID:The significance of nipple discharge: diagnosis and treatment regimes. 972 9

Although carcinoma of the breast complicates 1:3000 deliveries in the US, most breast conditions unique to pregnancy and lactation are benign--for example, lactating adenoma, galactocele, gigantomastia, and benign bloody nipple discharge. Nevertheless, malignancy must be excluded by a thorough work-up, including breast biopsy if indicated; "watchful waiting" when a breast mass is discovered is no more appropriate than in a nonpregnant patient. During lactation, the major problems encountered often are part of a spectrum of inflammatory and infectious complications. Nasopharyngeal organisms from the infant are usually the source of breast infections in lactating women. Keeping the breast empty of milk promotes healing by helping to drain the culture medium that is facilitating growth of organisms. Hence, the earlier recommendations that breast-feeding cease during mastitis have been superseded by the knowledge that breast-feeding is generally not harmful to the infant and may speed resolution of the infectious process. The diagnosis and management of pregnancy-associated breast cancer (PABC) is reviewed. Pregnancy-associated masses are usually discovered by patient self-examination, and the clinician should proceed to fine-needle aspiration or biopsy, rather than mammography, which has poor sensitivity during pregnancy and lactation because of increased breast density. Management of a new breast mass in pregnancy should maximize diagnostic accuracy and minimize the chances of missing PABC, yet avoid harm to the fetus or interruption of lactation.
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PMID:Diagnosing and Managing Breast Disease During Pregnancy and Lactation. 974 91

Breast health care was rarely acknowledged in the health and science fields prior to this century and has only begun, in recent years, to receive attention outside of pregnancy/lactation or cancer screening and treatment. Yet much health care is involved with regard to this reproductive and sexual organ. With any group of clients, practitioners of women's health care must address an assortment of breast health matters. This article offers an overview of the history of breast health care, the epidemiology of benign breast conditions and cancer, the anatomy and physiology of the breast, and breast development over the lifespan. Also presented are a review of breast assessment and examination, suggestions for routine care of the breast, and an overview of major health issues related to this reproductive organ. Health issues addressed include, among others, nodular and cystic changes, nipple discharge, breast/nipple pain, mastitis, elective alterations, and cancer. Discussion is focused on the latest approaches to optimal breast health care.
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PMID:Breast health care. A review. 987 76

Nipple discharge disorders is a field in which there has been both increasing awareness on the part of patients and advances in management. Today secretion from nipples can be classified according to its color, cellularity and biology. To be significant a discharge should be true, spontaneous, persistent and non-lactational. Moreover there are methods to differentiate patients who require surgical intervention from those who do not. Surgically significant nipple discharges are watery, serous (yellow), serosanguineous and bloody. Cytology smears of discharge material have helped to classify the cellular material, providing information about normality, atypia and malignancy and also about papillary formation of the exfoliated cells. Tests such as Hemoccult help to discover occult blood in the secreted fluid. Modern immunological tests can be performed on cytology smears where occurrence of high levels of carcinoembryonic antigen could indicate a latent malignancy. Galactography investigation is today the state-of-the-art approach to investigate patients with nipple discharge disorders and this examination can demonstrate the size, location and extent of an intraductal abnormality. Modern high-resolution ultrasound techniques are helpful in visualizing intraductal disorders and are becoming a good complementary approach if not an alternative to traditional radiology techniques. Recently even MR galactography has been shown to be of diagnostic value, but not as informative as regular galactography. The most sophisticated investigation method, which can also be used therapeutically, is fiber-ductoscopy of the concerned duct in a breast. This technique, although expensive and in its infancy, is a fascinating and promising approach for inspecting the intraductal lumina. In this article the background, current investigation methods and possibilities of the technique are described, as well as the most sophisticated ways to deal with nipple discharge disorders in human breasts.
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PMID:Nipple discharge disorders: current diagnostic management and the role of fiber-ductoscopy. 1035 67

Among 253 cases of nipple discharge, 96 cases of them were diagnosed as intracanalicular papilloma(37.9%), 73 cases as cystic disease of breast(28.9%), 41 cases as mammary duct ectasia (16.2%), 35 cases as breast cancer(13.8%) and 8 cases as acute suppurative mastitis(3.2%). The masses beneath areolar region were smaller those outside areola. Finding of cancer cells or suspicious cancer cells through cytologic examination of nipple discharge smear and breast mass puncture usually had important significance. In addition, near infrared ray scanning shows high rate of correct diagnosis; estimation of carcinoembryonic autigen(CEA) in nipple discharge is beneficial to the early diagnosis of malignant diseases.
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PMID:[The diagnosis and treatment of nipple discharge in 253 cases]. 1068 69

The most common breast problems for which women consult a physician are breast pain, nipple discharge and a palpable mass. Most women with these complaints have benign breast disease. Breast pain alone is rarely a presenting symptom of cancer, and imaging studies should be reserved for use in women who fall within usual screening guidelines. A nipple discharge can be characterized as physiologic or pathologic based on the findings of the history and physical examination. A pathologic discharge is an indication for terminal duct excision. A dominant breast mass requires histologic diagnosis. A breast cyst can be diagnosed and treated by aspiration. The management of a solid mass depends on the degree of clinical suspicion and the patient's age.
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PMID:The evaluation of common breast problems. 1079 75

The retroprospective study of breast cancer in relation to benign breast lesions (BBL) involved an analysis of the breast cancer incidence in a cohort of women with a history of BBL. This cohort was formed on the basis of histological and cytological investigations performed during 1982-1991. A total of 10,776 cases with BBI were recorded, followed-up and analyzed. The total person-years of follow-up was 60,872. A total of 35 women with breast cancer were detected during the study. Cohort members with a BBL history were stratified into six subcohorts with respect to morphological and cytological patterns. Comparison of the observed breast cancer incidence with the expected breast cancer incidence calculated on the basis of the age-adjusted breast cancer incidence in the general population showed no significant rise in breast cancer incidence in the whole BBL cohort. The ratio of observed to expected incidence rates was 1.16. The analysis of subcohorts with diverse BBL patterns demonstrated a marked increase in breast cancer incidence only in the intraductal papilloma and cyst subcohorts. The ratios of observed and expected rates were 5.4 and 1.6, respectively. There was no significant difference from population levies of breast cancer risk in subcohorts with history of fibroadenoma, fibrocystic disease, breast nipple discharge and other lesions. Similar results were obtained in the prospective part of the study.
Eur J Cancer Prev 1998 Feb
PMID:Benign lesions and cancer of the breast. 1086 34

In case of abnormal nipple discharge of the female breast galactography is a recognized radiological procedure to identify and to localize intraductal growths or other ductal abnormalities. However, it harbours several methodological problems. In ductal orientated sonography the availability of high frequency linear transducers enables us now to visualize the mammary ducts in detail. The aim of this study was to compare both methods with respect to the detection of the cause of pathological nipple discharge. Thirty-five patients were first examined by ductal orientated sonography with a 13 MHz linear transducer. The results of sonography were recorded in detail before galactography was performed. Ductal abnormalities were found by sonography in 26 patients and by galactography in 19 patients. In 24 cases both methods revealed concurring results. Among those, 17 cases showed pathological findings and seven cases had normal ducts. In nine patients sonography revealed pathological results whereas galactography was completely normal. In only two cases sonography failed to show ductal abnormalities which were detected by galactography. Our study underlines that ductal orientated sonography is a promising method of diagnosis in abnormal nipple discharge, which may be recommended to be performed routinely before galactography.
Eur J Cancer Prev 1998 Feb
PMID:Ductal orientated sonography improves the diagnosis of pathological nipple discharge of the female breast compared with galactography. 1086 37


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