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Breast Cases
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Unknown Case 5
42 y/o F with presents with left nipple discharge. What is the most likely diagnosis?
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INTRADUCTAL PAPILLOMA
Symptomatic bloody or clear nipple discharge: especially if unilateral, spontaneous, persistent
Central – within a major subareolar duct and often solitary
Peripheral – within a TDLU and may be multiple; higher likelihood of malignancy
Mammo: dilated duct(s) or circumscribed mass
Filling defect on galactogram
US: intraductal mass with vascular stalk; dilated fluid-filled duct
Tx (controversial): Surgical excision, especially if associated with atypia
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