Pathologic Nipple Discharge

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Pathologic nipple discharge:
    • Is characteristically spontaneous, unilateral, or bloody
  • Physiologic discharge:
    • Is non-spontaneous, bilateral, and milk
  • The most common causes for pathologic nipple discharge:
    • Are benign:
      • Intraductal papillomas
      • Duct ectasia
  • The presence of abnormal clinical findings on imaging or physical exam:
    • Is associated with increased risk of malignancy:
      • 38% vs. 2%
  • Contemporary workup for nipple discharge includes:
    • Mammography
    • Evaluation of the retroareolar region with ultrasound
  • Patients with normal findings on mammography, ultrasound, and physical exam:
    • Can be further evaluated with breast MRI:
      • As it is highly sensitive and specific for cancer
  • Surgical management of nipple discharge includes:
    • Excision of a single duct or central duct apparatus:
      • Depending on the number of ducts involved
  • References:
    • Li GZ, Wong SM, Lester S, Nakhlis F. Evaluating the risk of underlying malignancy in patients with pathologic nipple discharge. Breast J. 2018;24(4):624-627.
    • de Paula IB, Campos AM. Breast imaging in patients with nipple discharge. Radiol. Bras. 2017;50(6):383-388.
    • Yilmaz R, Bender O, Celik Yabul F, Dursun M, Tunaci M, Acunas G. Diagnosis of nipple discharge: value of magnetic resonance imaging and ultrasonography in comparison with ductoscopy. Balkan Med J. 2017;34(2):119-126.
Unknown's avatar

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

Leave a comment