Management Strategies of Nipple Discharge

Document Type : Original Article


The Department of General Surgery, Shibin El-Kom Teaching Hospital


Abstract Background: Nipple discharge (ND) is defined as a fluid that flows or is expressed from the mammary ducts. Nipple discharge is classified as benign or pathologic on the basis of its clinical characteristics. Unilateral spontaneous bloody or clear nipple discharge from a single duct may be the first sign of breast carcinoma needing further evaluation. Aim of Study: The aim of this study is to assess manage-ment strategies for patients with nipple discharge (ND). Patients and Methods: This study was carried out on 50 female patients who presented with nipple discharge in the out patient clinics of Shebin El-Kom Teaching Hospital. Lactating females were excluded from the study. Patients were followed up for a minimum of 3 months and a maximum of 18 months on monthly basis. Results: The success rate of conservative management for benign ND was 88%. The discharge immediately stopped in patients managed by microdochectomy but hematoma developed in only one case that got resolved spontaneously. The discharge stopped in all patients managed by major duct excision, Discharge stopped immediately, but recurrence occured in two patients with purulent discharge. They need revision surgery for further debridement. In cases presented with a lump and FNAC showed malignant cells 16% (4 cases) they managed by modified radical mastectomy, the wound disrupted in one case, it occurs at the mammary fold and managed by secondary sutures later on. Conclusion: This study reveals the accuracy of clinical examination, sonomammography & FNAC in evaluating breast lump especially when applied together.