APPROACH TO THE BLOOD STAINED NIPPLE DISCHARGE

Abstract

38 patients with spontaneous bloody nipple discharge were treated between the years 1988-1991 in our Breast Unit. Mean age was 39 (range 24 to 67). Patients were mostly in 4th and 5th decade. Nipple discharge was unilateral in 26 and bilaterat in 12 patients. Histologically papillomatozis was diagnosed in four (%15) patients with unilateral discharge and two (%22) patients with bilateral discharge. Among the 9 patients who were diagnosed as papillomatozis by the galactographic examination, histologically two of them (%22) were papillomatozis and other seven were fibrous dysplasla with duct ectasia and papillomatous changes. 25 of 38 patients underwent cytological examination and ductal cell groups and foam cells were observed; histologically six (%24) had papillomatozis, 14 (%56) fibrous dysplasla with papillomatous changes, five (%20) fibrous dysplasla with ductal ectasia. Among the 6 patients with bloody nipple discharge associated with breast lump, histologically four of them (%66) were carcinoma and two (%33) were fibrocystic disease with papillomatous changes.

10 patients were treated by retroareolar ducts excision, seven extended duct excision, 17 duct excision, four modified radical mastectomy. According to our results, patients younger than 40 years old with bloody nipple discharge can be treated with duct or extended duct excision; patients above 40 years old can be treated with excision of retroareolar ducts.