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

Carcinoma of the breast is relatively uncommon in men. Represents somewhere between 0.9 to 1.5 of all tumors of the breast. Most patients are within the 7th to 8th decade of life. The most common symptoms at the time of presentation are a tumor mass in either breast, ulceration of the nipple or nipple retraction or fixation of the skin. Extension to the axiliar nodes takes place early in the course of the disease. The presence of nipple discharge should be considered expression of carcinoma of the breast unless otherwise proven. The final diagnosis is established by biopsy. The most common form of carcinoma of the breast is the ductal carcinoma. The surgical management takes basically that followed in carcinoma of the breast in the female patient. Also orquiectomy has been used which is equivalent to ovariectomy in woman. In the presence of metastasis both estrogens and androgens have been used. Hypophysectomy and post-op radiation therapy has been used. Most recently chemotherapy has been widely used in those cases with widespread metastasis. However, in spite of all these efforts carcinoma of the breast in the male still carries a very serious prognosis. We present our experience in 16 cases.
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PMID:[Breast cancer in men]. 23 66

Sixteen cases of male breast cancer seen over a 20-year period were reviewed. The causes of cancer of the male breast are no better understood, but major alterations in hormonal environment could be a significant factor. Some clinical characteristics correspond well with the results of other series. The median age at presentation was 61.7 years. The most frequent initial symptom was a painless mass, and the incidences of nipple discharge, central tumor location, and axillary node involvement were high. Males also had a higher incidence of local advancement which was associated with a longer delay in seeking treatment and small breast tissue. The pathologic type was infiltrating ductal type in all cases except one, and all cases showed favorable nuclear grade. Estrogen receptor analysis was performed from the tumor of 2 patients. Both of them showed a high receptor level. There was no locoregional relapse in 5 patients who received adjuvant radiotherapy in contrast to the 2 relapses in 3 patients who underwent surgery alone. And three of the five patients who received radiotherapy suffered from systemic metastasis which suggested the important role of adjuvant chemotherapy as well as radiotherapy. In light of the encouraging results about adjuvant chemotherapy in the treatment for female breast cancer with axillary lymph node involvement, it would be desirable to extend this policy to male breast cancer.
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PMID:Male breast cancer--a 20-year review of 16 cases at Yonsei University. 217 38

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

A case of non-invasive secretory carcinoma of the breast is reported. The patient was a 33-year-old Japanese woman who complained of abnormal nipple discharge from the right breast. Although physical and radiological examinations failed to find any abnormal nodular lesions in the breast, a cytological examination revealed signet-ring-like atypical cells in the smears of nipple discharge. Radical mastectomy with axillary lymph nodes dissection was performed. No nodular lesions were macroscopically observed. However, intraductal proliferation of atypical cells was microscopically found in the excised breast. Diastase-resistant PAS-positive mucus was observed in the tumor-cell-forming-lumina and in the cytoplasm of tumor cells. No metastases were observed in the axillary lymph nodes.
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PMID:[Non-invasive secretory carcinoma of the breast]. 359 81

A retrospective review of 28 male breast cancer patients at Eastern Virginia Medical School and affiliated hospitals was performed to learn about patient characteristics, treatment, and outcome. The mean age of the patients was 64 years, and 60 per cent of patients were obese. The most common presenting symptoms were mass in 79 per cent and nipple discharge in 29 per cent. The median duration of symptoms was 3.3 months. All patients except two underwent mastectomy, and most tumors were early stage (0, I, or II). Many patients, particularly those with advanced disease, were also treated with chemotherapy, radiation therapy, and/or endocrine therapy. At a median follow-up of 29 months, the actuarial 5-year survival was 43 per cent, somewhat worse than the survival of female breast cancer patients in the literature. Male breast cancer patients are treated in a similar fashion to female patients. Aggressive systemic treatment should be considered for patients with poor prognosis disease. The high frequency of estrogen receptor positivity suggests tamoxifen may prove to be particularly useful in these patients.
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PMID:Cancer of the male breast. 797 72

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.
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PMID:Ductal carcinoma in situ of the male breast. Analysis of 31 cases. 907 92

In 20 years we registered 10 observations of male breast cancer (MBC), representing 1.3% out of 767 patients with breast cancer. Two observations of gynecomastia have been noted as a possible risk factor for MBC. A tumoral mass behind the areola suggested the diagnosis in 9 patients, whether in one case the attention was drawn by a bloody nipple discharge. In 3 cases we noted local aggravation clinical signs, and 6 observations presented homolateral palpable adenopathy. Diagnosis was completed by radiology, scintigraphy and pathology. As for clinical staging, we had 1 case in stage I,3 patients in stage II, 5 in stage III and I case in stage IV. Surgical treatment was the major therapeutical mean of the complex oncological procedure. We performed radical mastectomy in 4 cases. MBC prognosis was poor. Only one patient of the 6 ones in stage III and IV survived to five years; among other 4 observations in stage I and II, 2 patients have survived to five years, and other 2 being followed-up through the oncological network.
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PMID:[Breast cancer in men]. 928 65

Currently, mammography is the only method of detecting nonpalpable, early breast cancer. At this stage, 90% of the cancers are curable. Clearly, this fundamental tenet accentuates the importance of compliance and knowledge of guidelines. Although risks of mammography are minimal to nil, interpretation occasionally can be challenging, with equivocal results. New technologies are being evaluated and advances in measurement of cellular electrical potential differentials in breast tissue have produced exciting results, when compared with mammography and ultrasound. These screening efforts have increased the diagnosis of both invasive and noninvasive ductal and lobular carcinoma of the breast. For DCIS in particular, conservative, contemporary treatment options exist. These include lumpectomy with breast irradiation excluding axillary dissection. Selected patients may be treated with only lumpectomy. Although breast carcinoma is a major focus due to incidence, morbidity and mortality, the varieties of benign conditions cause many women genuine concern. Treatment options for fibrocystic change run a gamut, including cost-effective basic dietary changes, vitamin use, "health"/natural type treatments, analgesic, as well as hormonal manipulations and, on occasion, surgical intervention. Fortunately, with most patients, common sense and conservatism prevail. The presence of fibroadenomas diagnosed clinically, by ultrasound or mammography, in women aged 18-25 and beyond can create perplexing diagnostic dilemmas. Should the lesion be removed or observed? Differences of opinion exist and must be tempered by recent observations that women with complex fibroadenomas, sclerosing adenosis, epithelial calcification or papillary appocrine changes have a two- to threefold increased risk of breast cancer. The key to management in all these clinical situations is individualization. Conservatism is particularly acceptable in women under the age of 25 if a fibroadenoma is not increasing in size or not psychologically disturbing. Provoked or unprovoked nipple discharge is a clinical conundrum for patients. It is unsuspected and unwanted. While some whitish discharges result from stimulation or medication, others may have a more subtle etiology. Serous, serosanguineous, or bloody discharges mandate evaluation. Duct injection mammography and frequent excision of ductal systems are necessary. The clinician cannot forget other less common conditions, such as thrombophlebitis, fat necrosis, or infection. All clinical conditions of the breast provide a constellation of diagnostic and management problems. They are of real concern for every woman and must be resolved in an appropriate, prompt, and conscientious fashion.
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PMID:Breast disease: a primer on diagnosis and management. 940 32

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

Male breast carcinoma accounts for 1% of all diagnosed breast carcinoma. Pure ductal carcinoma in situ in men is extremely rare. Unfortunately, male breast cancer is often diagnosed at a late stage because of the minimal awareness of presenting symptoms by the patient and sometimes by the health care provider. Because of this late presentation, the overall prognosis is less favorable. This case is presented to emphasize the importance of recognizing bloody nipple discharge as a clinical sign of male ductal carcinoma in situ and an opportunity for early diagnosis.
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PMID:Male ductal carcinoma in situ presenting as bloody nipple discharge: a case report and literature review. 1189 58


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