Nipple Discharge

Mammary Duct Ectasia

  • Benign
  • Smoking is a major risk factor
  • Nipple discharge, often blood stained
  • Mastalgia (non-cyclical)
  • Nipple inversion/retraction
  • Occasional associated with a palpable subareolar mass.
  • Treat conservatively and it often settles spontaneously.
  • If persists surgical excision is an option.

 

Intraductal Papilloma

  • Usually present around the post menopause
  • Can present with a serous or bloody discharge from the nipple
  • Small (2-3mm) wart like lesion within a breast duct
  • They can obstruct the duct causing cysts or twist and become necrotic causing bleeding
  • Investigate with breast ductography (injection of contrast to visualise the breast ductal system).
  • Benign but can represent and increase risk of cancer
  • Treated mostly with surgical excision and vigilant breast screening

 

Breast Abscess

  • An acute(usually bacterial) infection of the breast tissue
  • May be associated with fever, pus discharge from the nipple and local erythema, tenderness and heat
  • Treat with antibiotics. May require incision and drainage surgically.
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