TY  - CHAP
M1  - Book, Section
TI  - Chapter 57. Central Duct Exploration for Nipple Discharge
A1  - Sclafani, Lisa M.
A2  - Kuerer, Henry M.
Y1  - 2010
N1  - 
T2  - Kuerer's Breast Surgical Oncology
AB  - Nipple  discharge  affects  5%  to  30%  of  women  during  their  lifetime.  Surgery  is  rarely  indicated.  Many  benign  conditions  cause  nipple  discharge,  including  duct  ectasia,  cystic  disease,  papillomas,  infection,  and  abnormal  production  of  prolactin.  In  addition,  many  medications  can  produce  discharge.  Discharges  are  usually  categorized  as  physiologic  or  pathologic,  depending  on  their  color,  frequency,  and  the  involvement  of  single  or  multiple  ducts.  Those  discharges  that  are  bilateral,  creamy  or  greenish  in  color,  draining  from  multiple  ducts,  nonspontaneous,  and  associated  with  an  otherwise  normal  physical  exam  and  mammogram  are  rarely  due  to  cancer  or  papillomas  and  do  not  require  surgery  except  rarely  for  relief  of  symptoms.  Clinical  characteristics  that  suggest  a  pathologic  discharge  are  unilateral  discharge  through  a  single  duct;  the  presence  of  a  bloody,  clear,  or  serous  discharge;  discharge  that  is  spontaneous;  and  those  associated  with  a  mass.  Pathologic  discharges  usually  require  surgery  to  rule  out  a  malignant  cause,  although  cancer  as  a  cause  of  nipple  discharge  is  unusual.1-3  In  a  series  of  204  patients  presenting  to  a  multidisciplinary  group  with  nipple  discharge,  only  7  (3%)  were  found  to  have  cancer  or  9%  of  those  ultimately  referred  for  surgery.2  In  a  group  of  82  patients  referred  to  a  surgical  clinic  with  pathologic  nipple  discharge  (spontaneous  red  or  serous  discharge  from  a  single  duct),  4  were  found  to  have  cancer  (5%).  Advanced  age  has  been  seen  to  be  a  predictor  of  cancer  in  women  with  nipple  discharge.1,2  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesssurgery.mhmedical.com/content.aspx?aid=6414020
ER  -