title: Surgical approach to nipple discharge: a ten-year experience.
abstract: OBJECTIVE
  The actual relationship between malignancy and secreting breast has not yet been extensively verified, mainly in patients with nipple discharge but without evidence of a breast lump. This study was carried out in 1,251 consecutive patients to evaluate the reliability of cytology combined with galactography in order to assess the relationship of malignant and premalignant lesions with discharge without the presence of a breast lump.
  
  
  METHODS
  Those patients with bilateral discharge were approached endocrinologically, whereas the patients (433) with unilateral secretion were evaluated by cytology, mammography, fine needle biopsy, and galactography. Of 194 patients without a breast lump, 94 with positive cytology were surgically treated after mammogalactography. Surgical treatment included ductgalactophorectomy in 53, segmentectomy in 23, microdochectomy in 13, and mastectomy in 5 patients.
  
  
  RESULTS
  Pathologic findings showed a solitary papilloma in 49 cases, minimal breast cancer in 20, fibrocystic disease in 11, papillomatosis in 7, lobular cancer in 5, and, finally, a duct ectasia in 2.
  
  
  CONCLUSIONS
  In the patients with secreting breast but without lump, cytological analysis in addition to galactography seems to be useful in identifying minimal breast cancer and in detecting premalignant lesions like papillomatosis.
authors.affiliation: Division of General Surgery, Faculty of Medicine, University of Messina, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Gioffrè Florio
authors.forename: T
authors.initials: T
authors.lastname: Manganaro
authors.forename: A
authors.initials: A
authors.lastname: Pollicino
authors.forename: P
authors.initials: P
authors.lastname: Scarfo
authors.forename: B
authors.initials: B
authors.lastname: Micali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000175:diagnosis; D005122:Exudates and Transudates / Q000166:cytology; D005260:Female; D005348:Fibrocystic Breast Disease / Q000175:diagnosis; D006801:Humans; D008327:Mammography; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009558:Nipples / Q000378:metabolism*; D010212:Papilloma / Q000175:diagnosis; D011230:Precancerous Conditions