Surgical outcomes of total duct excision in the diagnosis and management of nipple discharge.
Ann R Coll Surg Engl
; 106(6): 515-520, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38497796
ABSTRACT
INTRODUCTION:
Total duct excision (TDE) is performed for the diagnosis and management of nipple discharge. The Association of Breast Surgery's recent guidelines recommend considering diagnostic surgery for single-duct, blood-stained or clear nipple discharge, and for symptomatic management.METHODS:
We retrospectively reviewed the diagnostic and surgical outcomes of all cases of TDE between January 2013 and November 2019.RESULTS:
In total, 259 TDEs were carried out 219 for nipple discharge, 29 for recurrent mastitis, 3 for screening abnormalities and 8 for breast lumps. Of the nipple discharge group, 121 had blood-stained discharge. Mean patient age was 52 years (range 19-81). Median follow-up time was 45 months (interquartile range 24-63). The following cases were identified on histopathology 236 benign breast changes, 10 atypical ductal hyperplasia, 4 lobular carcinoma in situ, 2 low-grade ductal carcinoma in situ (DCIS), 3 intermediate-grade DCIS, 2 high-grade DCIS and 2 invasive ductal carcinomas. In total, 3.5% of patients who underwent TDE had a diagnosis of DCIS or invasive carcinoma. Blood-stained discharge was associated with a significant increase in risk of DCIS or carcinoma compared with other nipple discharge colours (p = 0.043). The most common complications of TDE were infection, poor wound healing and haematoma. Nipple discharge recurred in 14.2% of cases.CONCLUSIONS:
TDE can be considered for the diagnostics and management of nipple discharge. Blood-stained nipple discharge increases the risk of DCIS or malignancy, but the majority of the time TDE reveals benign breast pathology.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Mama
/
Derrame Papilar
Limite:
Adult
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Aged
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Aged80
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Female
/
Humans
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Middle aged
Idioma:
En
Revista:
Ann R Coll Surg Engl
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Reino Unido