Document Detail

Navigating murky waters: a modern treatment algorithm for nipple discharge.
MedLine Citation:
PMID:  18005783     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Many women with nipple discharge undergo operative duct excision with few actually having carcinoma. METHODS: We reviewed all patients with nipple discharge at our institution from 2001 to 2005. Clinical findings were analyzed to determine an appropriate treatment algorithm. RESULTS: Nipple discharge was present in 204 patients. Carcinoma was identified in 7 patients (3% of all, 9% of those undergoing biopsy). Age > or = 50 years, abnormal mammography, and abnormal sonography were the only significant predictors of carcinoma. Among patients with unilateral, spontaneous, bloody, or serous discharge with a negative mammogram, the carcinoma risk was 3%. Among patients with unilateral, spontaneous, bloody, or serous discharge with a negative mammogram and subareolar ultrasound, the carcinoma risk was 0%. CONCLUSIONS: Patients with nipple discharge can be divided into risk groups by combining clinical and radiologic findings. Low-risk patients can be offered close clinical follow-up rather than operation. A recommended management algorithm is presented.
Richard J Gray; Barbara A Pockaj; Patricia J Karstaedt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  194     ISSN:  1879-1883     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-16     Completed Date:  2007-12-11     Revised Date:  2009-05-20    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  850-4; discussion 854-5     Citation Subset:  AIM; IM    
Department of General Surgery, Mayo Clinic Arizona, 5777 E. Mayo Blvd, Phoenix, AZ 85054, USA.
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MeSH Terms
Aged, 80 and over
Body Fluids
Breast Diseases / diagnosis*,  radiography
Breast Neoplasms / diagnosis
Carcinoma, Intraductal, Noninfiltrating / diagnosis
Middle Aged
Nipples* / radiography
Retrospective Studies
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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