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What is the next step for evaluation of nipple discharge in a non-lactating woman?

What should be performed for a patient who has nipple discharge. By: Dr. Seyed Reza Samsamshariat Note: The present slides can be used if the reference is mentioned.

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What is the next step for evaluation of nipple discharge in a non-lactating woman?

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  1. What should be performed for a patient who has nipple discharge.By: Dr. Seyed Reza SamsamshariatNote: The present slides can be used if the reference is mentioned.

  2. Nipple discharge may occur in a male or in a non-lactating female and is the symptom caused by several situations. In males there is usually an endocrine abnormality and in females the etiologies are more variable.

  3. By the way the nipple discharge represents an abnormal symptom and the underlying disease should be diagnosed.

  4. What is the next step for evaluation of nipple discharge in a non-lactating woman?

  5. How is the discharge of the nipple collected for cytopathologic examination? With special pump With pressure on areola

  6. The benign lesions causing nipple discharge :

  7. The prevalence of malignancy when nipple discharge is seen

  8. The sensitivity of the cytopathologic examination of the nipple discharge. The Cytopathologic results of the nipple discharges were as below in women with breast carcinoma:

  9. Except the cytopatologic examination of the nipple discharge the values of the other tests ( as biochemistry or microbiology) are Inappreciable. • Variation of biochemical parameters in non-malignant and malignant discharge • Parameters Non-malignant malignant • CEA (µg mL-1) 5.0 10.0 • LDH (µ L-1) 50.0 120.0 • Protein (mg dL-1) 20.0 10.0 • Cholesterol (mg dL-1) 80.0 40.0 • Triglyceride (mg dL-1) 45.0 20.0 • Occult blood (%) 25.0 Nil

  10. Cytopathology of the nipple secretion ( and touch imprint preparations of the biopsy samples) can predict the patient’s survival who has breast cancer. The presence of the sex chromatin ( arrows ) in 20% or more of the malignant cells which are seen in the cythopathologic or touch imprint samples means a favorable behavior of tumor regardless of tumor grade or stage at the time of biopsy.

  11. References:

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