Duct Excision is Still Necessary to Rule out Breast Cancer in Patients Presenting with Spontaneous Bloodstained Nipple Discharge

Table 4

Patients with benign diagnoses at duct excision, who subsequently represented with breast cancer.

Age at original presentation	Initial presentation	Initial diagnosis	Time to re-presentation	Side	Subsequent presentation	Further histology	Treatment
63	Bloodstained single-duct nipple discharge	ADH	16 months	Contralateral	Serous nipple discharge dipstick +++ for blood	2 mm grade 2 node negative IDC +DCIS + duct papilloma	Mx + ANC
77	Bloodstained single-duct nipple discharge	ADH	48 months	Ipsilateral	Asymmetric density seen on screening mammogram follow up	16 mm grade 2 node negative IDC	Mx + ANC
49	Serous single-duct nipple discharge	Duct papilloma, duct ectasia and fibrocystic disease	84 months	Contralateral	Breast pain and nodularity	23 mm grade 2 node negative IDC + DCIS	Mx + ANC + reconstruction. Recurrence in reconstructio 15 months later treated with WLE + DXT (15 mm grade 3 IDC)
52	Bloodstained single-duct nipple discharge	Fibrocystic disease	94 months	Ipsilateral	Lump in axilla	Metastatic adenocarcinoma from presumed occult breast primary	ANC
59	Bloodstained single-duct nipple discharge	Duct ectasia	54 months	Ipsilateral	Lump	22 mm grade 2 node negative IDC	WLE + ANC + DXT
62	Brown single-duct nipple discharge	Duct papilloma	56 months	Ipsilateral	Bloodstained nipple discharge	Two adjacent <5 mm grade 2 node negative IDC	Mx + ANC
67	Serous single-duct nipple discharge	Duct papilloma	26 months	Contralateral	Bloodstained nipple discharge and nodularity	13 mm grade 2 node negative IDC, DCIS + multiple duct papillomas	WLE + ANS + DXT
76	Clear single-duct nipple discharge	Duct papilloma + duct ectasia	6 weeks	Contralateral	New lump	14 mm grade 2 node negative IDC	Mx + ANC

Histology: DCIS: ductal carcinoma in situ; IDC: Invasive ductal carcinoma.
Treatment: Mx: mastectomy; ANS: axillary node sampling; ANC: axillary node clearance; WLE: wide local excision; DXT: radiotherapy.