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

Microdochectomy has been the routine management for single-duct nipple discharge. Our review of 176 consecutive patients surgically treated between 1975 and 1988 revealed eight patients with in situ carcinomas and seven with infiltrative carcinomas. Seventeen patients had multiple papillomas, two had atypical hyperplasia and two had atypical epitheliosis. Case selection for surgery has recently been advocated. In our study, nipple discharge cytology was helpful in 67 per cent of cases with underlying malignant pathology. Mammography was found to be unreliable, alerting suspicion in only two of 15 cases.
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PMID:Preoperative cytology and mammography in patients with single-duct nipple discharge treated by surgery. 225 95

43 women with spontaneous bloody nipple discharge were examined by galactography performed with water soluble contrast medium. The purpose of this study was to evaluate the use of galactography in these patients, to localize the cause of this particular type of discharge and to register the therapeutic consequences of the findings. Surgical resection was carried out in all cases where galactography showed intraductal pathology. The remaining patients (except for four who also underwent surgery) were observed without treatment. No sign of carcinoma was found in a follow-up examination of the non-operated patients after two to four years. The results show that galactography can be suitably used to demonstrate and localize intraductal pathology, and may therefore be of importance in the preoperative investigation of spontaneous blood-stained secretion.
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PMID:[Contrast mammography in spontaneous bloody secretion from the nipple]. 227 45

Since 1977 mass screening for breast cancer has been conducted in Miyagi Prefecture, Japan; inspection, palpation and cytologic examination of any nipple discharge are part of the initial screening procedures. Among 149,681 subjects examined, 404 cancer cases and 63 papilloma cases were detected. The nipple discharges from 20,537 women were examined cytologically; of the 61 cancer cases, the smears were positive in 18 cases, suspicious in 7, negative with atypical findings in 12 and negative in 24. Ten of the cancer cases were detected exclusively by the cytologic examination of a nipple discharge. In eight of these ten cancer cases, there was no other initial evidence of the primary tumor. The cytologic diagnosis of discharges without blood from 28 cancer cases was positive or suspicious in 10 cases and negative in 18. Thirty-seven of the papilloma cases were initially detected only by the cytologic examination of a nipple discharge; neither physical examination nor mammography showed any abnormal findings.
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PMID:Nipple discharge cytology in mass screening for breast cancer. 232 48

Five cases of bloody nipple discharge during pregnancy without associated breast masses were seen over the past 3 years by the author. Because of the reported association of breast cancer with bloody nipple discharge, close follow-up of these women at monthly intervals during pregnancy and trimonthly during the postpartum period was carried out. In all instances, the discharge appeared late during the second trimester or during the third trimester of pregnancy. It was unilateral and spontaneous and arose from multiple ducts, and it was associated with an increase in breast size and always with the larger breast of the two. The discharge cytologic study done on all cases was negative for neoplastic cells and the discharges resolved spontaneously within 2 months of onset. Postpartum follow-up ranging from 6 months to 3 years has revealed no evidence of neoplastic changes thus far. Mammograms ordered before these patients were referred were not helpful due to the increase in density of the breast tissue secondary to the pregnancy. Because a few cases of breast cancer during pregnancy have presented solely with a bloody nipple discharge, I recommend extremely close follow-up of these women and no surgical intervention unless a mass is discovered or the nipple discharge cytology is either suspicious or positive at the initial visit or during follow-up.
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PMID:Bloody nipple discharge during pregnancy: a rationale for conservative treatment. 232 21

Intraductal papillary tumors of the breast exhibit bloody nipple discharge with often no evidence of a palpable tumor, making discrimination between benign and malignant lesions sometimes difficult for pathologists and surgeons. However, appropriate surgical management requires correct differentiation between these lesions. According to previously reported 3-dimensional analyses of intraductal papillary lesions, solitary papilloma originates in the large ducts while multiple papilloma originates in the peripheral ducts and often coexists with intraductal carcinoma. We performed selected ductolobular segmentectomy on both solitary and multiple intraductal papilloma, and even on small foci of intraductal carcinoma which were found inadvertently. The favorable results of this surgery include a fine cosmetic appearance, functional breast feeding and no recurrence of papilloma during the 2 to 7 year follow-up period. In this article, the operative method of selected ductolobular segmentectomy is described.
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PMID:The operative management of intraductal papilloma of the breast. 234 42

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


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