Central Duct Excision and Nipple Discharge

Introduction

Nipple discharge is the third most common breast complaint for which women will see a physician. The majority of nipple discharge is benign. Nipple discharge can be characterized as physiologic or pathological. Physiologic nipple discharge is often bilateral, expressed from multiple ducts, and color can range from green to creamy. Pathological nipple discharge is spontaneous, unilateral, single duct, and bloody or serous ( Fig. 57.1 ). The causes of pathological nipple discharge include benign papilloma, ductal ectasia, and malignancy (reported in 5% to 15% of cases). The goal of the nipple discharge evaluation is to determine which patients need surgery to rule out malignancy.