Clinicopathological features of bloody nipple discharge

Objective To identify the clinicopathological features of bloody nipple-discharge.Methods The medical records of 435 patients with pathologic nipple discharge (PND) who were admitted from June 2001 to May 2006 were reviewed; the findings of imaging study and methods of surgical intervention were also analyzed.Results Papilloma was the most common diagnosis (58.9%) in patients with bloody nipple discharge, whereas hyperplasia was the most common diagnosis in patients with non-bloody nipple discharge. The incidence of carcinoma was 14.0% in patients with bloody nipple-discharge compared with 7.0% in patients with non-bloody nipple discharge. In breast image studies, MRI and mammary ductoscopy were more accurate than others. Mammary ductoscopy-directed duct excision for PND was safer and more effective procedure than intraductal injection of methylene blue dye to assist in major duct excision.Conclusion Patients with bloody nipple-discharge and a palpable mass are in high risk of breast cancer. Mammary ductoscopy for PND is a safe, effective procedure for major duct excision.