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Is duct excision still necessary for all cases of suspicious nipple discharge?
- Source :
-
The breast journal [Breast J] 2012 Mar-Apr; Vol. 18 (2), pp. 157-62. Date of Electronic Publication: 2011 Dec 30. - Publication Year :
- 2012
-
Abstract
- Despite the low likelihood of malignancy, it is recommended that all women with pathologic nipple discharge undergo duct excision based on the inadequate sensitivity of diagnostic modalities. However, these data originates prior to recent improvements in breast imaging. We performed a retrospective review of patients evaluated in the setting of modern diagnostic breast imaging. Of 175 women referred to our breast clinic with a primary complaint of nipple discharge, 142 (81%) had suspicious discharge. Of the 23 patients who opted for observation over duct excision, with a mean follow-up of 3.3 years, none have been diagnosed with cancer. Among patients who proceeded with surgery, cancer was diagnosed in seven patients (5%). Six of the seven patients had either an abnormal mammogram or ultrasound. Among 46 patients with suspicious nipple discharge, a normal physical exam and normal diagnostic mammogram/ultrasound, only one malignancy (2%) was identified in a 79-year-old patient with a personal history of breast cancer. In selected patients with suspicious nipple discharge, but normal physical exam and diagnostic imaging, short-term observation with repeat evaluation seems reasonable for patients who do not desire duct excision.<br /> (© 2011 Wiley Periodicals, Inc.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Biopsy
Breast Diseases diagnostic imaging
Breast Neoplasms diagnostic imaging
Breast Neoplasms pathology
Exudates and Transudates
Female
Follow-Up Studies
Humans
Mammography
Middle Aged
Nipples diagnostic imaging
Nipples pathology
Retrospective Studies
Young Adult
Breast Diseases diagnosis
Breast Diseases surgery
Breast Neoplasms surgery
Nipples metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4741
- Volume :
- 18
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The breast journal
- Publication Type :
- Academic Journal
- Accession number :
- 22211878
- Full Text :
- https://doi.org/10.1111/j.1524-4741.2011.01207.x