Description
The commonest cause of nipple discharge is the squeezing of the nipple by the patient to check for any discharge as part of their self-examination. A nipple discharge is of significance if it is spontaneous, persistent and non-lactational. The finding of an associated breast lump and single duct discharge increase the likelihood of the discharge being due to a pathological cause. The evaluation of patients with nipple discharge is based on the patients history / physical examination, imaging and pathological evaluation (Triple assessment). While the role of ductography and fibre-ductoscopy remains controversial, mammography and ultrasound have been shown to be useful in diagnosis. Cytology is an important adjunct in the investigative
work up of nipple discharge disorders, but as with the other investigations mentioned above, it is not sensitive enough to be used as the sole selective tool in deciding for surgery. Microdochectomy is the procedure of choice for single duct discharge and total duct excision may be indicated in cases
of multiple duct discharge.
