USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

(Kiana) #1

BLOODY NIPPLE DISCHARGE


A   60-year-old woman   comes   to  the gynecologist’s  office  complaining of  a
left breast bloody nipple discharge.

Diagnosis. A bloody nipple discharge usually results from an intraductal
papilloma. The treatment is total excision of the duct and papilloma through a
circumareolar incision. Modern ductography does not reliably exclude
intraductal pathology and is not a substitute for surgery in patients with
pathologic discharge. Its utility is in identifying multiple lesions or lesions in the
periphery of the breast.


Management. Treatment is based on the established histologic diagnosis.

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