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

A milky discharge from the nipple and breast hypertrophy are often seen in mature infants, but bloody nipple discharge is very rare in infancy and childhood. In adults, a bloody discharge may be associated with breast carcinoma, but in infants it is a benign, self-limited condition that should be managed conservatively. Surgical procedures should be avoided, because injury to the breast bud may cause permanent damage. We report a 3-month-old girl who presented with a bloody discharge from the left nipple. The discharge diminished gradually in the course of time and ceased completely at the age of 9 months.
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PMID:[Bloody nipple discharge in an infant]. 139 18

This study was aimed at determining the role of high-frequency (7.5 MHz) US combined with cytology in the diagnosis of complex breast nodules (complex cysts--cystic tumors). The study population included 60 patients presenting with complex breast nodules selected on the basis of US patterns among 3,000 cases. All patients were also submitted to US-guided fine-needle aspiration biopsy (FNAB). Cytology of nipple discharge was always performed when discharge was present (15 cases), mammography was performed in 50 cases and pneumocystography in 10. US allowed the identification of the lesion in all patients and the diagnosis of nature in 73%; with FNAB the figure reached 96.7%. Mammography identified the lesion in 95% of patients, but failed to reveal the complex nature of the nodule. In a small number of cases mammography proved to be a useful complementary tool demonstrating malignant features not recognizable on US images. On the contrary, pneumocystography yielded no further information with respect to US. Diagnostic control was obtained by means of surgery in 30 patients and of clinical-US follow-up in the extant 30 cases. On the basis of their US features the lesions were classified into two groups: I) nodules having a mainly liquid component--i.e., hemorrhagic, septic, multilocular cysts, papillary cystadenoma; II) nodules having a mainly solid component--i.e., solitary intraductal papilloma, intracystic carcinoma, mixed carcinoma, phylloid adenoma, sarcoma. As to the former group, US proved reliable in making a diagnosis in the cases with typical hemorrhagic, septic and multilocular cysts. In the atypical cases, FNAB of the solid component of the nodule was necessary to differentiate irregular clots, thick septa or inflammatory thickening from different conditions. As to the latter group, FNAB of the solid component and/or mammography proved useful in making a diagnosis, even though to this aim US revealed peculiar patterns which were highly suggestive. In our experience, combined US and FNAB are of basic importance in the diagnosis of breast lesions, thus replacing pneumocystography which has been widely employed so far. As regards mammography, its role seems limited to pointing out the peculiar characters of malignancy which could not be demonstrated otherwise.
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PMID:[The diagnostic imaging of complex breast nodules]. 141 Jun 63

This article briefly reviews breast cancer examination and discusses a variety of physical changes that may occur in the breast suffering from breast cancer. The selected topics include evaluation of breast masses, nipple discharge, nipple changes other than discharge, and a discussion of inflammatory breast cancer and its differentiation from mastitis. Breast cancer appearing as a solitary axillary mass is also discussed. A brief discussion is also undertaken of aspiration cytology, mammographically directed needle localized open biopsies, and mammographically directed or stereotactic needle aspirations for cytology.
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PMID:Physical and mammographic diagnosis of breast cancer and initial work-up. 146 Feb 18

We measured carcinoembryonic antigen (CEA) in 43 cases with abnormal nipple discharge by means of enzyme immunoassay utilizing monoclonal anti-CEA antibodies. When the cut-off value was set at 400 ng/ml so that the cases where measured values are not less than this value may be interpreted to be positive, the sensitivity and specificity were 60% and 75% respectively. The clear relationship was virtually observed between the concentration of CEA in nipple discharge and the cytological diagnosis. 9 of 10 malignant cases showed positive in both or either of the CEA assay and the cytological examination. And we could find 1 case of the zero stage of breast cancer and 4 cases in non-invasive carcinoma (Tis) through the combined diagnosis. On the other hand, only 2 of 8 benign cases showed false positive results. The correlation between the CEA concentration in nipple discharge and intratumoral expression of CEA was also observed. In this study, we concluded that the combined use of the enzyme immunoassay and the cytological examination would be more effective in the detection of early breast cancer accompanied with abnormal nipple discharge.
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PMID:[Clinical usefulness of carcinoembryonic antigen measurement in nipple discharge as an adjunctive tool for diagnosis of breast cancer]. 154 28

Gynecomastia and bloody nipple discharge are very rare in childhood. In this report, a case of infantile gynecomastia together with bloody nipple discharge is presented. A hemorrhagic discharge was expressible from the mammary gland. Endocrinologic findings were within the normal limits. Because of persisting bleeding, a subcutaneous mastectomy was performed. The specimen was reported as gynecomastia. This boy is the first reported prepubertal gynecomastia with bloody nipple discharge in the medical literature.
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PMID:Infantile gynecomastia with bloody nipple discharge. 155 26

Single-duct microdochectomy is described for use in patients with bloody or serosanguinous nipple discharge arising from a single duct in the breast. Because most such cases are caused by benign, intraductal papillomata, the technique used in removing the offending ductal system should be fully diagnostic, adequately therapeutic, and cosmetically acceptable. A technique is described that is used in 40 consecutive patients with good diagnostic, therapeutic, and cosmetic result. The procedure itself combines techniques and principles of plastic and reconstructive surgery such as minimal tissue trauma, use of anatomical tissue planes, bloodless-field surgery, and microdissection.
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PMID:Transareolar dye-injection microdochectomy. 161 85

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

A fiberoptic ductoscopy system was successfully developed by means of which we were able to observe the duct cavity of the breast. Two kinds of silicafiberscopes with outer diameters 0.80 and 0.45 mm were used in the present study. Fiberoptic ductoscopy was applied to 52 ducts in 46 patients with nipple discharge for whom no tumor was palpable; the intraductal appearance could be observed in 47 ducts from 41 patients (90.3%). Fourteen ducts from 13 patients were operated upon and were histologically diagnosed as carcinoma (four cases), intraductal papilloma (nine ducts from eight patients) and mastitis (one case). The internal surface of a normal duct was lustrous and smooth. Cancer growing on the surface of a duct wall appeared white and was slightly elevated, forming a bridging structure. The intraductal papillomas formed intraductal solid nodules, being yellow in most cases and red at the site of hemorrhage. Fiberoptic ductoscopy can be used to recognize the growth of minute intraductal lesions in cases of nipple discharge. Clinical endoscopic diagnosis for minute intraductal lesions will make an important contribution to the early detection of cancer and the evaluation of nipple involvement in intraductal carcinoma.
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PMID:Fiberoptic ductoscopy of the breast: a new diagnostic procedure for nipple discharge. 165 13

Pleomorphic adenomas of the breast (PAB) are uncommon tumors. We studied the clinicopathologic features of 10 cases of PAB, seven of which were assessed immunohistochemically. Nine patients were women, with a median age at diagnosis of 65 years. Eight patients presented with a palpable mass; two had a nipple discharge. Nine of the tumors were periareolar. The latter epidemiologic findings, coupled with histologic observations, appeared to indicate a preferential origin for PAB within large intramammary ducts. These neoplasms histologically resemble their analogues in salivary glands. Moreover, a gradual histologic transition between different morphologic areas in PAB, especially between mesenchymal and epithelial regions, supported the contention that the neoplasm arises from a single cell type capable of divergent differentiation and thus should not be considered a "mixed" tumor. This contention was further substantiated by immunohistochemical findings, in which three intermediate filaments (cytokeratin, vimentin, and glial fibrillary acidic protein) and muscle-specific actin were expressed conjointly in tumor cells with a variety of morphologic appearances. In addition, cells differentiating along mesenchymal lines by conventional microscopy were found to express epithelial membrane antigen or gross cystic disease fluid protein-15 in five cases. The benign nature of PAB was supported by a lack of metastases in this series during a median follow-up period of 4.9 years. However, one lesion recurred locally. Regarding therapy, we believe that PAB can be excised successfully with only a narrow circumferential margin of uninvolved breast.
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PMID:Pleomorphic adenoma of the breast: a clinicopathologic and immunohistochemical study of 10 cases. 166 Aug 50

We report two cases of neuroendocrine carcinomas of the breast displaying unusual histological features: numerous spindle cells and argyrophilic signet-ring cells. Both patients were older than 70 years, and both presented with a bloody nipple discharge. The tumor in both cases was predominantly intraductal. The tumor cells showed little pleomorphism or cytological atypia; because of the presence of spindle cells, benign diagnoses, such as ductal epithelial hyperplasia and intraductal papilloma, were considered for the in situ component. Recognition of the palisading arrangement of the peripheral cells, intracytoplasmic lumina, mitotic figures, and mucin permitted the diagnosis of intraductal carcinoma. Invasive nests composed of identical cells confirmed the diagnosis of malignancy in both cases. Our cases, along with those previously reported, suggest that neuroendocrine carcinoma with mucin production is a distinct breast tumor that usually occurs in older patients who experience bloody nipple discharge. The prognosis may be more favorable than that of the usual type of breast carcinoma. Common histological features include predominantly intraductal growth, an absence of desmoplasia, and low-grade atypia. Awareness of morphological variants of this tumor, such as those reported here, is necessary to avoid erroneous diagnoses.
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PMID:Spindle-cell argyrophilic mucin-producing carcinoma of the breast. Histological, ultrastructural, and immunohistochemical studies of two cases. 171 95


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