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Nipple Discharge

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Management of Breast Diseases

Abstract

Nipple discharge is not an uncommon complaint of women seeking evaluation at a breast center. Despite advances in testing and imaging, pathologic nipple discharge remains a clinical diagnosis that requires differentiation between benign physiologic and pathologic characteristics. While most cases of pathologic nipple discharge are the result of benign proliferative lesions, malignancy can present as nipple discharge in a small proportion of cases. Excision is appropriate for most cases of nipple discharge that are deemed pathologic, and a directed excision is helpful to ensure lesion removal. This chapter reviews the incidence, etiology, associated findings, evaluation, and treatment of nipple discharge.

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References

  1. Devitt JE. Management of nipple discharge by clinical findings. Am J Surg. 1985;149:789.

    Article  CAS  PubMed  Google Scholar 

  2. Gulay H, Bora S, Kilicturgay S, Hamaloglu E, Goskel HA. Management of nipple discharge. J Am Coll Surg. 1994;178:471–4.

    CAS  PubMed  Google Scholar 

  3. Chaudary M, Millis R, Davies G, et al. Nipple discharge: the diagnostic value of testing for occult blood. Ann Surg. 1982;196:651.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Van Zee K, Ortega P, Minnard E, Cohen M. Preoperative galactography increases the diagnostic yield of major duct excision for pathologic nipple discharge. Cancer. 1988;82(10):1874–80.

    Article  Google Scholar 

  5. Waaijer L, Simons J, Borel Rinkes H, et al. Systematic review and meta-analysis of the diagnostic accuracy of ductoscopy in patients with pathologic nipple discharge. BJS. 2016;103:632–43.

    Article  CAS  Google Scholar 

  6. Zucca-Matthes G, Urban C, Vallejo A. Anatomy of the nipple and breast ducts. Gland Surgery. 2016;5(1):32–6.

    PubMed  PubMed Central  Google Scholar 

  7. Goodson WH, King EB. Discharges and secretions of the nipple. In: Bland KI, Copeland EM, editors. The breast: comprehensive management of benign and malignant diseases. 2nd ed. Philadelphia: WB Saunders; 1998. p. 51–74.

    Google Scholar 

  8. Sartorius OW, Smith HS, Morris P, et al. Cytological evaluation of breast fluid in the detection of breast diseases. J Natl Cancer Inst. 1977;59:1073–80.

    Article  CAS  PubMed  Google Scholar 

  9. Sauter ER, Daly M, Linahan K, et al. Prostate-specific antigen levels in nipple aspirate fluid correlate with breast cancer risk. Cancer Epidemiol Biomark Prev. 1996;5(120):967–70.

    CAS  Google Scholar 

  10. Petrakis NL, Mason L, Lee R. Association of race, age, menopausal status, and cerumen type with breast fluid secretion in nonlactating women as determined by nipple aspiration. J Natl Cancer Inst. 1975;54:829–34.

    CAS  PubMed  Google Scholar 

  11. Sauter E, Wagner-Mann C, Ehya H, et al. Biologic markers of breast cancer in nipple aspirate fluid and nipple discharge are associated with clinical findings. Cancer Detect Prev. 2007;31(1):50–8.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Wrensch MR, Petrakis NL, Gruenke LD, et al. Factors associated with obtaining nipple aspirate fluid: analysis of 1,428 women and literature review. Breast Cancer Res Treat. 1990;15(1):39–51.

    Article  CAS  PubMed  Google Scholar 

  13. Lang J, Kuerer H. Breast ductal secretions: clinical features, potential uses, and possible applications. Cancer Control. 2007;14(4):350–9.

    PubMed  Google Scholar 

  14. Petrakis NL. Physiologic, biochemical, and cytologic aspects of nipple aspirate fluid. Breast Cancer Res Treat. 1986;8:7–19.

    Article  CAS  PubMed  Google Scholar 

  15. Papanicolaou GN, Bader GM, Holmquist DG. Exfoliative cytology of the human mammary gland and its value in the diagnosis of cancer and other diseases of the breast. Cancer. 1958;11:337–409.

    Article  Google Scholar 

  16. Petrakis NL, Lee RE, Miike R, et al. Coloration of breast fluid related to concentration of cholesterol, cholesterol epoxides, estrogens and lipid peroxides. Am J Clin Pathol. 1988;89:117–20.

    Article  CAS  PubMed  Google Scholar 

  17. Santen RJ, Mansel R. Benign Breast disorders. N Engl J Med. 2005;353(3):275–85.

    Article  CAS  PubMed  Google Scholar 

  18. Seltzer MH. Breast complaints, biopsies, and cancer correlated with age in 10,000 consecutive new surgical referrals. Breast J. 2004;10:111–7.

    Article  PubMed  Google Scholar 

  19. Dillon M, NaMohd Nazri S, Nasir S, et al. The role of major duct excision and microdochectomy in the detection of breast carcinoma. BMC Cancer. 2006;6:164.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ciatto S, Bravetti P, Cariaggi P. Significance of nipple discharge clinical patterns in selection of cases for cytologic examination. Acta Cytol. 1986;30(1):17–20.

    CAS  PubMed  Google Scholar 

  21. Leis HP Jr. Management of nipple discharge. World J Surg. 1989;13(6):736–42.

    Article  PubMed  Google Scholar 

  22. Tabar L, Dean PB, Pentek Z. Galactography: the diagnostic procedure of choice for nipple discharge. Radiology. 1983;149:31–8.

    Article  CAS  PubMed  Google Scholar 

  23. Dawes LG, Bowen C, Luz VA, Morrow M. Ductography for nipple discharge: no replacement for ductal excision. Surgery. 1998;124(4):685–91.

    Article  CAS  PubMed  Google Scholar 

  24. Paterok EM, Rosenthal H, Sabel M. Nipple discharge and abnormal galactogram. Results of a long-term study (1964–1990). Eur J Obstet Gynecol Reprod Biol. 1993;50:227–34.

    Article  CAS  PubMed  Google Scholar 

  25. Lau S, Kuchenmeister I, Stachs A, et al. Pathologic nipple discharge: surgery is imperative in postmenopausal women. Ann Surg Oncol. 2005;12(7):246–51.

    Article  Google Scholar 

  26. Vargas H, Perla Vargas M, Eldrageely K, et al. Outcomes of clinical and surgical assessment of women with pathological nipple discharge. Am Surg. 2006;72:124–8.

    PubMed  Google Scholar 

  27. Cabioglu N, Hunt KK, Singletary SE, et al. Surgical decision-making and factors determining a diagnosis of breast carcinoma in women presenting with nipple discharge. Am Coll Surg. 2003;196(3):354–64.

    Article  Google Scholar 

  28. Carty NJ, Mudan SS, Ravichandran D, Royle GT, Taylor I. Prospective study of outcome in women presenting with nipple discharge. Ann R Coll Surg Engl. 1994;76:387–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Dietz JR, Crowe JP, Grundfest S, et al. Directed duct excision by using mammary ductoscopy in patients with pathologic nipple discharge. Surgery. 2002;132:582–7.

    Article  PubMed  Google Scholar 

  30. Johnson TL, Kini SR. Cytologic and Clinicopathologic features of abnormal nipple secretions: 225 cases. Diagn Cytopathol. 1991;7:17–22.

    Article  CAS  PubMed  Google Scholar 

  31. Wong Chung J, Jeuriens-van de Ven J, Helmond N, et al. Does nipple discharge color predict (pre-) malignant breast pathology? Breast J. (2016);22(2):202–8.

    Google Scholar 

  32. Copeland M, Higgins T. Significance of discharge from the nipple in nonpuerperal mammary conditions. Ann Surg. 1960;151(5):638–48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Arnold G, Neiheisel M. A comprehensive approach to evaluating nipple discharge. Nurse Pract. 1997;22(7):96–111.

    Article  CAS  PubMed  Google Scholar 

  34. Newman HF, Klein M, Northrup JD, et al. Nipple discharge: frequency and pathogenesis in an ambulatory population. NY St J Med. 1983;83:928.

    CAS  Google Scholar 

  35. Huang W, Molitch M. Evaluation and management of galactorrhea. Am Fam Physician. 2012;85(11):1073–80.

    PubMed  Google Scholar 

  36. Haagensen DD (1971) Diseases of the breast., 2nd edn. WB. Saunders, Philadelphia.

    Google Scholar 

  37. Zuska JJ, Crile G Jr, Ayres NW. Fistulas of lactiferous ducts. Am J Surg. 1951;81:312–7.

    Article  CAS  PubMed  Google Scholar 

  38. Fiorica JV. Nipple discharge. Obstet Gynecol Clin North Am. 1994;21:453–60.

    CAS  PubMed  Google Scholar 

  39. Liu GY, Lu JS, Shen KW, Wu J, Chen CM, et al. Fiberoptic ductoscopy combined with cytology testing in the patients of spontaneous nipple discharge. Breast Cancer Res Treat. 2008;108:271–7.

    Article  PubMed  Google Scholar 

  40. Lafreniere R. Bloody nipple discharge during pregnancy and/or lactation: a rational for conservative treatment. J Surg Oncol. 1990;43:228–30.

    Article  CAS  PubMed  Google Scholar 

  41. Sakai T, Makita M, Akiyama F, Uehara K, et al. Intraductal papilloma with bloody discharge from Montgomery’s areolar tubercle examined by ductoscopy from the areola. Breast Cancer. 2006;13(1):104–6.

    Article  PubMed  Google Scholar 

  42. Bauer RL, Eckhert KH Jr, Nemoto T. Ductal carcinoma in situ-associated nipple discharge: a clinical marker for locally extensive disease. Ann Surg Oncol. 1998;5(5):452–5.

    Article  CAS  PubMed  Google Scholar 

  43. Cardenosa G, Eklund GW. Benign papillary neoplasms of the breast: mammographic findings. Radiology. 1991;181:751–5.

    Article  CAS  PubMed  Google Scholar 

  44. Carter D. Intraductal papillary tumors of the breast. Cancer. 1977;39:1689–92.

    Article  CAS  PubMed  Google Scholar 

  45. Ohuchi N, Abe R, Kasai M. Possible cancerous change of intraductal papilloma of the breast. Cancer. 1984;54:605–11.

    Article  CAS  PubMed  Google Scholar 

  46. Hou MF, Huang TJ, Liu GC. The diagnostic value of galactography in patients with nipple discharge. Clin Imaging. 2001;25:75–81.

    Article  CAS  PubMed  Google Scholar 

  47. Fung A, Rayter Z, Fisher C, et al. Preoperative cytology and mammography in patients with single-duct nipple discharge treated by surgery. Br J Surg. 1990;77(11):1211–2.

    Article  CAS  PubMed  Google Scholar 

  48. Teboul M. A new concept in breast investigation: echo-histological acino-ductal analysis or analytic echography. Biomed Pharmacoth. 1988;42:289–96.

    CAS  Google Scholar 

  49. Feige C. Dynamic morpho-cyto-echography and the echographic galactoscopy endoductal sample; intrinsic and extrinsic markers in the detection of breast cancers. Ultrasound Med and Biol. 1988;14(1):97–108.

    Article  Google Scholar 

  50. Rissanen T, Reinikainen H, Apaja-Sarkkinen M. Breast sonography in localizing the cause of nipple discharge. J Ultrasound Med. 2007;26:1031–9.

    Article  PubMed  Google Scholar 

  51. Chung SY, Lee K, Park KS, Lee Y, Bae SH. Breast tumors associated with nipple discharge: correlation of findings on galactography and sonography. Clin Imaging. 1995;9(3):165–71.

    Article  Google Scholar 

  52. Blum K, Rubbert C, Antoch G, et al. Diagnostic accuracy of abnormal galactographic and sonoraphic findings in the diagnosis of intraductal pathology in patients with abnormal nipple discharge. Clin Imaging. 2015;39:587–91.

    Article  PubMed  Google Scholar 

  53. Cilotti A, Campassi C, Bagnlesi P, et al. Pathologic nipple discharge. High resolution versus conventional ultrasound in the evaluation of ductal disease. Breast Dis. 1996;9:1–13.

    Google Scholar 

  54. Ballesio L, Maggi C, Savelli S, et al. Adjunctive diagnostic value of ultrasonography evaluation in patients with suspected ductal breast disease. Radiol Med. 2007;112:354–65.

    Article  CAS  PubMed  Google Scholar 

  55. Sardanelli F, Imperiale A, Zandrino F, et al. Breast intraductal masses. Ultrasound-guided fine needle aspiration after galactography. Radiology. 1997;204:143–8.

    Article  CAS  PubMed  Google Scholar 

  56. Govindarajulu S, Narreddy SR, Shere MH, et al. Sonographically guided mammotome excision of ducts in the diagnosis and management of single duct nipple discharge. EJSO. 2006;32:725–8.

    Article  CAS  PubMed  Google Scholar 

  57. Torres-Tabanera M, Alonso-Bartolome P, Vega-Bolivar A, Sanchez-Gomez SM, et al. Percutaneous microductectomy with directional vacuum-assisted system guided by ultrasonography for the treatment of breast discharge: experience in 63 cases. Acta Radiol. 2008;49(3):271–6.

    Article  CAS  PubMed  Google Scholar 

  58. Yoshimoto M, Kasumi F, Iwase T, Takahashi K, Tada T, Uchida Y. Magnetic resonance galactography for a patient with nipple discharge. Breast Cancer Res Treat. 1997;42:87–90.

    Article  CAS  PubMed  Google Scholar 

  59. Ballesio L, Maggi C, Savelli S, et al. Role of breast magnetic resonance imaging (MRI) in patients with unilateral nipple discharge: preliminary study. Radiol med. 2008;113:249–64.

    Article  CAS  PubMed  Google Scholar 

  60. Morrogh M, Morris E, Liberman L, et al. The predictive value of ductography and magnetic resonance imaging in the management of nipple discharge. Ann Surg Oncol. 2007;14(12):3369–77.

    Article  PubMed  Google Scholar 

  61. Bahl M, Baker J, Greenup R, et al. Evaluation of pathologic nipple discharge: What is the added diagnostic value of MRI? Ann Surg Oncol. 2015;22:S435–41.

    Article  PubMed  Google Scholar 

  62. Hirose M, Nobusawa H, Gokan T. MR ductography: comparison with conventional ductography as a diagnostic method in patients with nipple discharge. Radiographics. 2007;27:S183–96.

    Article  PubMed  Google Scholar 

  63. Hirose M, Otsuki N, Hayano D, Shinjo H, Gokan T, et al. Multi-volume fusion imaging of MR ductography and MR mammography for patients with nipple discharge. Magn Reson Med Sci. 2006;5(2):105–12.

    Article  PubMed  Google Scholar 

  64. Nicholson B, Harvey J, Patrie J, Mugler J. 3D-MR Ductography and contrast-enhanced MR mammography in patients with suspicious nipple discharge; a feasibility study. Breast J. 2015;21(4):352–62.

    Article  PubMed  Google Scholar 

  65. Takeda T, Matsui A, Sato Y, et al. Nipple discharge cytology in mass screening for breast cancer. Acta Cytol. 1990;34(2):161–4.

    CAS  PubMed  Google Scholar 

  66. Dunn JM, Lucarotti E, Wood SJ, et al. Exfoliative cytology in the diagnosis of breast disease. Br J Surg. 1995;82:789–91.

    Article  CAS  PubMed  Google Scholar 

  67. Florio M, Manganaro T, Pollicino A, et al. Surgical approach to nipple discharge: a ten-year experience. J Surg Oncol. 1999;71:235–8.

    Article  Google Scholar 

  68. Knight DC, Lowell D, Heimann A, Dunn E. Aspiration of the breast and nipple discharge cytology. Surg Gynecol Obstet. 1986;163:415–20.

    CAS  PubMed  Google Scholar 

  69. Moriarty A, Schwartz M, Laucirica R, et al. Cytology of spontaneous nipple discharge- is it worth it? Performance of nipple discharge preparations in the college of American pathologists interlaboratory comparison progrogram in nongynecologic cytopathology. Arch Pathol Lab Med. 2013;137:1039–42.

    Article  PubMed  Google Scholar 

  70. Ranieri E, Virno F, D’Andrea M, et al. The role of cytology in differentiation of breast lesions. Anticancer Res. 1955;15:607–12.

    Google Scholar 

  71. Kawamoto M. Breast cancer diagnosis by lactate dehydrogenase isoenzymes in nipple discharge. Cancer. 1994;73:1836–41.

    Article  CAS  PubMed  Google Scholar 

  72. Imayama IS, Mori M, Ueo H, et al. Presence of elevated carcinoembryonic antigen on absorbent disks applied to nipple area of breast cancer patients. Cancer. 1996;78(6):12229–34.

    Article  Google Scholar 

  73. Inaji H, Yayoi E, Maeura Y, Matsuura N, Tominaga S, Koyama H, et al. Carcinoembryonic antigen estimation in nipple discharge an adjunctive tool in the diagnosis of early breast cancer. Cancer. 1987;60:3008–13.

    Article  CAS  PubMed  Google Scholar 

  74. Nishiguchi T, Hishimoto T, Funahashi S, et al. Clinical usefulness of carcinoembryonic antigen measurement in nipple discharge as an adjunctive tool for diagnosis of breast cancer. Jpn J Clin Path. 1992;40(1):67–72.

    CAS  Google Scholar 

  75. Fortova L, Garber JE, Sadowsky NL, et al. Carcinoembryonic antigen in breast nipple aspirate fluid. Cancer Epidemiol Biomark Prev. 1998;7(3):195–8.

    Google Scholar 

  76. Liu Y, Wang JL, Chang H, et al. Breast-cancer diagnosis with nipple fluid bFGF (letter). Lancet. 2000;356(9229):567.

    Article  CAS  PubMed  Google Scholar 

  77. Sauter E, Shan S, Hewett J, et al. Proteomic analysis of nipple aspirate fluid using SELDI-TOF-MS. Int J Cancer. 2005;114:791–6.

    Article  CAS  PubMed  Google Scholar 

  78. Baker KS, Davey DD, Stelling CB. Ductal abnormalities detected with galactography: frequency of adequate excisional biopsy. Am J Roentgenol. 1994;162:821–4.

    Article  CAS  Google Scholar 

  79. Van Zee KJ, Perez GO, Minnard E, Cohen M. Preoperative ductography increases the diagnostic yield of major duct excision for nipple discharge. Cancer. 1998;82(10):1874–80.

    Article  PubMed  Google Scholar 

  80. Rongione AJ, Evans BD, Kling KM, McFadden DW. Ductography is a useful technique in evaluation of abnormal nipple discharge. Am Surg. 1996;62:785–8.

    CAS  PubMed  Google Scholar 

  81. Cardenosa G, Doudna C, Eklund GW. Ductography of the breast: techniques and findings. Am J Roentgenol. 1994;162:1081–7.

    Article  CAS  Google Scholar 

  82. Saarela AO, Kiviniemi HO, Rissanen TJ. Preoperative methylene blue staining of galactographically suspicious breast lesions. Int Surg. 1997;82(4):403–5.

    CAS  PubMed  Google Scholar 

  83. Hussain S, Lui DM. Ultrasound-guided percutaneous galactography. Eur J Radiol. 1997;24:163–5.

    Article  CAS  PubMed  Google Scholar 

  84. Urban JA. Excision of the major duct system of the breast. Cancer. 1963;16:516–20.

    Article  CAS  PubMed  Google Scholar 

  85. Jardines L. Management of nipple discharge. Am Surg. 1996;62:119–22.

    CAS  PubMed  Google Scholar 

  86. Tan W, Lim TC. Transareolar dye-injection microdochectomy. Am Surg. 1992;58(7):404–8.

    CAS  PubMed  Google Scholar 

  87. Sharma N, Huston T, Simmons R. Intraoperative intraductal injection of methylene blue dye to assist in major duct excision. Am J Surg. 2006;191:553–4.

    Article  PubMed  Google Scholar 

  88. Matsunaga T, Ohta D, Misaka T, et al. Mammary ductoscopy for diagnosis and treatment of intraductal lesions of the breast. Breast Cancer. 2001;8:213–21.

    Article  CAS  PubMed  Google Scholar 

  89. Shen KW, Wu J, Lu J, Han Q, Shen Z, Nguyen M, et al. Fiberoptic ductoscopy for patients with nipple discharge. Cancer. 2000;89:1512–9.

    Article  CAS  PubMed  Google Scholar 

  90. Escobar PF, Crowe JP, Matsunaga T, Mokbel K. The clinical applications of mammary ductoscopy. Am J Surg. 2006;191(2):211–5.

    Article  PubMed  Google Scholar 

  91. Al Sarakbi W, Salhab M, Mokbel K. Does mammary ductoscopy have a role in clinical practice? Int Semin Surg Oncol. 2006;3:16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  92. Louie LD, Crowe JP, Dawson AE, Lee KB, et al. Identification of breast cancer in patients with pathologic nipple discharge: does ductoscopy predict malignancy? Am J Surg. 2006;192:530–3.

    Article  PubMed  Google Scholar 

  93. Hunerbein M, Dubowy A, Raubach M, Gebauer B, Topalidis T, Schlag P. Gradient index ductoscopy and intraductal biopsy of intraductal breast lesions. Am J Surg. 2007;194:511–4.

    Article  PubMed  Google Scholar 

  94. Pereira B, Mokbel K. Mammary ductoscopy: past, present, and future. Int J Clin Oncol. 2005;10:112–6.

    Article  PubMed  Google Scholar 

  95. Hunerbein M, Raubach M, Gebauer B, Wolfgang S, Schlag P. Ductoscopy and intraductal vacuum-assisted biopsy in women with pathologic nipple discharge. Breast Cancer Res Treat. 2006;99:301.

    Article  PubMed  Google Scholar 

  96. Balci F, Feldman S. Interventional ductoscopy for pathologic nipple discharge. Ann Surg Oncol. 2013;20:3352–4.

    Article  PubMed  Google Scholar 

  97. Kamali S, Bender O, Harman Kamali G, et al. Diagnostic and therapeutic value of ductoscopy in nipple discharge and intraductal proliferations compared with standard methods. Breast Cancer. 2014;21:154–61.

    Article  PubMed  Google Scholar 

  98. Solin LJ, Recht A, Fourquet A, et al. Ten-year results of breast-conserving surgery and definitive irradiation for intraductal carcinoma of the breast. Cancer. 1991;68:2337–44.

    Article  CAS  PubMed  Google Scholar 

  99. Fowable BL, Solin LJ, Goodman RL. Results of conservative surgery and radiation for intraductal noninvasive breast cancer. Am J Clin Oncol. 1987;10:110–1.

    Google Scholar 

  100. Recht A, Danoff B, Solin LJ, et al. Intraductal carcinoma of the breast: results of treatment with excisional biopsy and radiation. J Clin Oncol. 1985;3:1339–43.

    Article  CAS  PubMed  Google Scholar 

  101. Ito Y, Tamaki Y, Nakano Y, et al. Nonpalpable breast cancer with nipple discharge: how should it be treated? Anticancer Res. 1997;17(1B):791–4.

    CAS  PubMed  Google Scholar 

  102. Dupont S, Boughey J, Jimenez R, et al. Surgery. 2015;158(4):988–95.

    Article  PubMed  Google Scholar 

  103. Foulkes R, Heard G, Boyce T, et. al. (2011) Int J Br Cancer 2011;article ID 495315.

    Google Scholar 

  104. Sabel M, Helvie M, Breslin T, et al. Is duct excision still necessary for all cases of suspicious nipple discharge? Breast J. 2011;18(2):157–62.

    Article  PubMed  Google Scholar 

  105. Ashfaq A, Senior D, Pockaj B, et al. Validation study of a modern treatment algorithm for nipple discharge. The Am J Surgery. 2014;208:222–7.

    Article  Google Scholar 

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  1. Surgery, University Hospitals Seidman Cancer Center, 3909 Orange Place, Suite 4400, Beachwood, Bentleyville, OH, 44122, USA

    Jill R. Dietz

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  1. Department of Surgery, University of Texas Health Science Center, San Antonio, Texas, USA

    Ismail Jatoi

  2. Obstetrics and Gynecology, University Medical Center Schleswig-Holstein, Luebeck, Germany

    Achim Rody

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Dietz, J.R. (2016). Nipple Discharge. In: Jatoi, I., Rody, A. (eds) Management of Breast Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-46356-8_3

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