Nipple discharge

Mary is 43 years old. Over the last 6 weeks she has noticed spontaneous discharge of fluid from a single duct in her right nipple. She has no other breast symptoms.

Clinical examination shows no nipple retraction or skin dimpling and a bead of brownish coloured fluid was visible on the right nipple. There were no palpable lumps or other abnormalities. Mammography was normal.

As Mary has a persistent, spontaneous single duct discharge a surgical procedure was recommended to excise the affected duct.

Microdochectomy is performed as a short day case procedure under a light general anaesthetic and allows removal of the affected duct and examination of this tissue in the laboratory. Once she is asleep a small probe is passed down the discharging duct. A cut is made around the areola and the nipple is elevated to display the underlying ducts. The affected duct is excised and the skin is closed.

       Nipple discharge and op markings                    Areola elevated to expose duct

       Skin closed - final result                       Histology papilloma within duct

Histology showed a small benign intraduct papilloma. This is a common cause for this problem. Excision is curative and Mary should not have any further problems.