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

Seven cases of carcinoma of male breast were reported. The mean age of them was about 65 years, 17 years older than that of female breast cancer. Six tumors out of 7 were located under the areola. By histological examination, 4 of 7 cases were proved to be noninvasive ductal carcinoma, and the others are invasive ductal carcinoma (2 : scirrhous, 1 : solid-tubular). We focused on clinicopathological features of noninvasive carcinoma. There were two points to be mentioned. One is the nipple discharge as a chief complaint, and the other is cyst formation as a macroscopic observation. These features are characteristic to noninvasive carcinoma and contribute to diagnosis. Therefore, for screening the mass of male breast, ultrasonography (U.S.) is most useful. For preoperative final diagnosis, aspiration or smear cytology is essential. In regard to postoperative survival, all of the 3 invasive cases were dead but all of the 4 noninvasive cases are alive. So the prognosis of noninvasive carcinoma of male breast does not appear to be worse than the female one. These observations indicate that the prognosis of carcinoma of male breast can be improved by early diagnosis and appropriate surgical therapy.
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PMID:[Carcinoma of male breast--with special reference to noninvasive carcinoma]. 254 34

The term ductal adenoma has been recently introduced to describe a solid benign lesion of breast ducts. This study describes the clinical, morphologic, and immunohistochemical features of 15 cases of ductal adenoma. Ductal adenomas are usually single, occasionally multiple, lesions occupying medium- and large-sized breast ducts. They may occur in women of all ages, although the majority of patients are 60 years of age or greater. Ductal adenomas usually present clinically as breast lumps which may mimic carcinoma; less commonly, they are associated with nipple discharge. Patients in this series showed no family or previous history of breast disease and had uneventful follow-up after local excision. Despite often showing worrying pseudoinfiltration and cytologic atypia, the immunohistochemical demonstration of a myoepithelial layer and intact basement membrane around the tubules was clear evidence of the benign nature of the lesions. We conclude that most ductal adenomas evolve by sclerosis of benign intraduct papillary lesions, although processes similar to sclerosing adenosis and, possibly, duct ectasia may contribute to the pathogenesis of a proportion of cases. It is hoped that a wider appreciation of the entity of ductal adenoma will reduce the diagnostic uncertainty that continues to surround these and related lesions.
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PMID:Ductal adenoma of the breast--a review of fifteen cases. 255 Mar 51

Two cases of noninvasive ductal carcinoma detected by galactography are reported with reference to our diagnostic methods of a patient with nipple discharge. Abnormal nipple discharge with no demonstrable breast lump is rare but an important clinical sign, since it is sometimes produced by malignant lesions. Non-contrast mammography and cytologic examination is of limited diagnostic value for abnormal nipple discharge. Galactography is necessary for the detection of ductal carcinoma in early stage. The most important factor in improving the survival statistics for breast carcinoma is early detection.
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PMID:Usefulness of galactography for minimal noninvasive ductal carcinoma of the breast. 255 51

Aspiration specimens from 12 patients with histologically documented ductal carcinoma-in-situ (DCIS) of the breast (seven patients) or DCIS with minute foci of stromal invasion (five) were evaluated. Five patients presented with palpable masses, 1.5-4.0 cm, and four patients presented with localized thickening, associated with nipple erosion and discharge in two of them. One patient had nipple inversion, and one patient had bilateral nipple discharge. In one patient, no apparent abnormality of the breast was present. Mammography was either suspicious for or strongly suggestive of carcinoma in 10 patients and negative in two. Aspirates from all patients were composed of fragments of atypical ductal epithelium and numerous single epithelial cells. In nine cases, the smears were hypercellular and similar to aspirates of typical invasive ductal carcinoma. Calcifications were present in six cases. In four of these, associated tumor necrosis was evident. Cytologic features separating DCIS patients from those showing minimal stromal invasion or common types of invasive ductal carcinoma (IDC) were not identified. We conclude that fine-needle aspiration cytology of DCIS is identical to that of IDC. If preoperative radiotherapy or chemotherapy is considered in the management of invasive breast carcinoma, cutting-needle biopsy for confirmation of tumor invasion is necessary.
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PMID:Ductal carcinoma-in-situ of the breast: fine-needle aspiration cytology of 12 cases. 255 63

To assess the morbidity associated with false alarms of breast cancer, 2923 consecutive consultations for a breast disorder were reviewed. 391 women had breast cancer, which was found by accidental discovery in 57%, by breast self-examination in 15%, by routine physical examination in 24%, and by screening mammography in 4%. 20% of women in whom cancers were found by physician screening had had a previous breast cancer. The pathological stages of tumours found by accident were little different from those found by intervention. 87% (2532/2923) of signs/symptoms of breast cancer were false alarms--ie, 86% (565/659) of those found by routine physical examination, 88% (406/462) breast self-examination, 93% (220/237) screening mammography, and 86% (1341/1565) accidental discovery. Spontaneous breast pain was responsible for 575 false alarms and nipple discharge for 126. 534 (20%) of the false alarms could have been avoided if routine physical examinations before the age of 45, breast self-examination before the age of 35, and screening mammography before the age of 60 had been discouraged. Another 30% of false alarms would have been avoided if the patient had realised that breast pain and nipple discharge are not usually symptoms of breast cancer.
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PMID:False alarms of breast cancer. 196 61

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


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