Nipple Discharge The Diagnostic Value of Testing for Occult Blood

Abstract

An analysis of 270 patients undergoing microdochectomy for nipple discharge from a single identifiable duct, and without an associated lump, revealed that occult cancers were all accompanied by Hb positive discharge. A simple method of detecting the presence of Hb in the discharge is described. The incidence of cancer was 5.9%. In order of frequency, intraduct papilloma, duct ectasia, cystic disease and carcinoma accounted for over 90% of the cases. Six patients in whom no malignancy was seen in the microdochectomy specimen subsequently developed cancer in the ipsilateral breast. A close follow-up of all patients with Hb positive discharge and in whom no cause for the discharge at microdochectomy is stressed.