Introduction: Isolated single-duct nipple discharge is worrying and poses a surgical dilemma. Factors predicting malignancy are controversial.Materials and Methods: Retrospective review of 92 consecutive microdochectomies for single-duct nipple discharge in a tertiary referral centre over 8 years. Results: The commonest causes were ductal papilloma (52%) and fibrocystic diseases of the breast (21%). Five (5%) patients had breast carcinoma, of whom only 1 had an invasive component. The median age of these patients was 43 years (range 26 to 72 years) which was similar to median age of the whole cohort. Sixty-seven (73%) patients presented with blood-stained nipple discharge. The 5 patients with breast carcinoma had blood-stained discharge. Mammography was abnormal in 1 out of 4 patients in the carcinoma group. Conclusions: The incidence of breast carcinoma in patients presenting with isolated single-duct nipple discharge was low (5%) among Singaporean women. There was no reliable predictors of malignancy, though all patients with carcinoma presented with bloodstained discharge. Microdochectomy still remains an effective treatment for nipple discharge both for cure and diagnosis.
Nipple discharge is a common disturbing symptom for many women and often leads to a surgical referral. It accounts for 3% to 5% of all breast symptoms.
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