Aim: This review article aims to provide a bird's-eye view for a surgeon dealing with a patient with Nipple discharge (ND).
Background: Nipple discharge is the third most common complaint of a woman visiting a breast clinic. It can be physiological, due to benign disorders like duct ectasia or can be a presenting symptom of breast cancer. Hence, it is extremely important to evaluate every patient with ND thoroughly with robust history and clinical examination followed by necessary investigations like ultrasonography and mammography (MMG).
Review results: Ultrasonography and MMG are the mainstays in the evaluation of ND. The role of magnetic resonance imaging, ductography, ductoscopy, and nipple aspiration cytology is not very well-defined and is evolving. Nonbreast etiologies of ND also need to be considered and relevant investigations to manage such patients are needed, clues for which lie in the presenting complaints of the patients. Various drugs also interfere with the physiology of breast secretions and are an important cause of ND and need to be managed appropriately. Management of ND should be directed toward the inciting cause of the disease. Surgical options include microdochectomy or a more radical Hadfield's surgery.
Conclusion: Directed investigations to determine the etiology of ND guided by clues found during the clinical examination of a patient can help in the appropriate treatment of ND and also avoid unnecessary surgery.
Clinical significance: Nipple discharge is one of the most common complaints with which a woman attends a breast clinic and needs to be approached systematically to identify the cause and decide on appropriate management strategies.
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