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Nipple Discharge

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Abstract

Papillary flow is the externalization of fluid material through the galactophores, outside the puerperal pregnant cycle. It responds/is responsible for approximately 5–10% of complaints in the mastology outpatient clinic. Milk secretion is called galactorrhea and non-milk secretion is called telorrhea.

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Recommended Reading

  1. Alcock C, Layer GT. Predicting occult malignancy in nipple discharge. ANZ J Surg. 2010;80(9):646–9. It corroborates with most of the published studies that the gold standard diagnosis-treatment for suspected papillary flow is microductectomy.

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  2. Liu M, Guo G, Xie F, et al. Mammary ductoscopy and follow-up avoid unnecessary duct excision in patients with pathologic nipple discharge. J Surg Oncol. 2015;112(2):139–43. It shows that ductoscopy, in specialized services, is an excellent diagnostic method for suspicious papillary flow.

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  3. Sanders LM, Daigle M. The rightful role of MRI after negative conventional imaging in the management of bloody nipple discharge. Breast J. 2016;22(2):209–12. In patients with suspected papillary flow and conventional negative tests (mammography and ultrasonography), magnetic resonance imaging is indicated by high negative predictive value.

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  4. Simmons R, Adamovich T, Brennan M, et al. Nonsurgical evaluation of pathologic nipple discharge. Ann Surg Oncol. 2003;10(2):113–6. Cytological evaluation of 108 patients with suspicious papillary flow, showing low specificity. It concludes that it should not be part of the diagnostic arsenal.

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  5. Wong Chung JE, Jeuriens-van de Ven SA, van Helmond N, et al. Does nipple discharge color predict (pre-) malignant breast pathology? Breast J. 2016;22(2):202–8. Evaluation of 184 patients with unilateral and uniductal papillary flow with bloody appearance. Twenty cases of carcinoma and twenty-one cases of atypical lesions were found. It was concluded that the presence of blood secretion should guide the surgical investigation.

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BBSG – Brazilian Breast Study Group. (2019). Nipple Discharge. In: Novita, G., Frasson, A., Millen, E., Zerwes, F., Cavalcante, F. (eds) Breast Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-13636-9_14

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  • DOI: https://doi.org/10.1007/978-3-030-13636-9_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-13635-2

  • Online ISBN: 978-3-030-13636-9

  • eBook Packages: MedicineMedicine (R0)

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