What is the treatment for breast duct discharge?

For breastfeeding women, nipples often secrete milk, so discharge is a normal phenomenon. But in addition to this, in daily life, women often have nipple discharge, which is definitely an abnormal phenomenon. It is likely caused by breast disease. Therefore, it is important to pay attention to it and closely observe whether there are other discomfort symptoms in the breast. After finding the cause based on these symptoms, symptomatic treatment should be given.

First, treatment

1. False discharge

When dealing with nipple discharge, you should first distinguish between true and false discharge. False discharge can be treated locally accordingly.

2. Treatment of true discharge

(1) Treatment of non-neoplastic discharge is often caused by mammary duct ectasia, cystic breast hyperplasia, etc. The former can be treated with drugs or surgery, and the latter can be treated with traditional Chinese medicine, drugs or surgery.

(2) Treatment of tumorous discharge is often caused by intraductal papilloma or intraductal papillary carcinoma. The former should undergo local segmental resection, while the latter should undergo radical mastectomy.

Second, diagnosis

1. Etiology diagnosis

When diagnosing the cause of nipple discharge in patients, in addition to a detailed medical history and physical examination, it is also necessary to carefully observe the type of discharge and whether it is a single-tube or multi-tube discharge. In addition, relevant auxiliary examinations should be performed to assist in diagnosis.

2. Assessment of the amount of fluid discharged

Except for the normal milk secretion during pregnancy and lactation, other nipple discharge is pathological. The amount of fluid discharged can be assessed in 5 levels. +++: No need to squeeze, just flow out naturally. ++: When lightly pressed, it sprays out in a thread-like shape. +: 2 to 3 drops flow out when strong pressure is applied. ±: Barely visible when strong pressure is applied. -: No discharge is observed even after compression. Evaluation of nipple discharge after treatment can also be used as a reference for evaluating the treatment effect.

Third, check

1. Laboratory examination

(1) Fluid cytology examination Fluid cytology examination is simple and convenient. It can detect breast cancer at an early stage and is a diagnostic method that is easily accepted by patients.

(2) Fine needle aspiration cytology examination of breast cancer: For patients with nipple discharge and breast masses, the correct diagnosis rate of fine needle aspiration cytology for breast cancer can reach 96%, while the correct diagnosis rate for benign diseases of nipple discharge is lower.

(3) Biopsy is the most reliable method to confirm the cause of nipple discharge, especially for early-stage microtumors, which require further diagnosis. If a puncture biopsy can be performed based on imaging localization, the diagnosis rate can be improved.

2. Other auxiliary examinations

(1) Near-infrared breast scanning: This method has a positive diagnostic rate of 80% to 90% for discharge caused by areolar duct diseases.

(2) Ultrasound examination: This method has an 80% to 90% accuracy rate in diagnosing the cause of benign breast diseases. Ultrasound examination can reveal enlarged milk ducts, very small cysts, and sometimes intraductal papilloma or filling defects.

(3) Selective breast ductography has great diagnostic value for nipple discharge and benign and malignant breast diseases, especially for patients with nipple discharge but no lumps or other signs on physical examination, or those with negative results on other examinations. Selective breast ductography can clarify the location, nature and extent of discharge before surgery.