SURGERY differencial diagnosis of nipple discharge 2.pptx

one dd of ca breast

1. SURGERY GENERAL SURGERY

2. 2.Nipple Discharge Nipple Discharge Nipple discharge refers to fluid secretion from one or both nipples, which can be physiological or pathological.

3. Types of Discharge Physiological (Benign): Milky (Galactorrhea) Clear or white Often bilateral and non-spontaneous Pathological: Bloody: Suggestive of malignancy (e.g., intraductal papilloma or carcinoma) Serous or serosanguinous: Possible malignancy or ductal ectasia Purulent: Associated with infection or abscess

4. History Taking: Unilateral vs. bilateral discharge Spontaneous or expressed Associated with a lump or pain Physical Examination: Examine for underlying masses Assess for duct openings and type of discharge Imaging and Tests: Mammogram/Ultrasound: Check for structural abnormalities. Ductography : For localized ductal lesions. Cytology: Assess for malignant cells in discharge

5. Causes Benign: Ductal ectasia Intraductal papilloma Mastitis or abscess Malignant: Ductal carcinoma in situ (DCIS) Invasive ductal carcinoma

6. Management Physiological Discharge: Reassurance and follow-up Address underlying cause (e.g., hyperprolactinemia) Pathological Discharge: Biopsy of any associated mass Excision of the involved duct in suspicious cases Multidisciplinary management for malignancy