Nipple Discharge

  • BBSG – Brazilian Breast Study Group


Papillary flow is the externalization of fluid material through the galactophores, outside the puerperal pregnant cycle. It responds/is responsible for approximately 5–10% of complaints in the mastology outpatient clinic. Milk secretion is called galactorrhea and non-milk secretion is called telorrhea.

Recommended Reading

  1. 1.
    Alcock C, Layer GT. Predicting occult malignancy in nipple discharge. ANZ J Surg. 2010;80(9):646–9. It corroborates with most of the published studies that the gold standard diagnosis-treatment for suspected papillary flow is microductectomy.CrossRefGoogle Scholar
  2. 2.
    Liu M, Guo G, Xie F, et al. Mammary ductoscopy and follow-up avoid unnecessary duct excision in patients with pathologic nipple discharge. J Surg Oncol. 2015;112(2):139–43. It shows that ductoscopy, in specialized services, is an excellent diagnostic method for suspicious papillary flow.CrossRefGoogle Scholar
  3. 3.
    Sanders LM, Daigle M. The rightful role of MRI after negative conventional imaging in the management of bloody nipple discharge. Breast J. 2016;22(2):209–12. In patients with suspected papillary flow and conventional negative tests (mammography and ultrasonography), magnetic resonance imaging is indicated by high negative predictive value.CrossRefGoogle Scholar
  4. 4.
    Simmons R, Adamovich T, Brennan M, et al. Nonsurgical evaluation of pathologic nipple discharge. Ann Surg Oncol. 2003;10(2):113–6. Cytological evaluation of 108 patients with suspicious papillary flow, showing low specificity. It concludes that it should not be part of the diagnostic arsenal.CrossRefGoogle Scholar
  5. 5.
    Wong Chung JE, Jeuriens-van de Ven SA, van Helmond N, et al. Does nipple discharge color predict (pre-) malignant breast pathology? Breast J. 2016;22(2):202–8. Evaluation of 184 patients with unilateral and uniductal papillary flow with bloody appearance. Twenty cases of carcinoma and twenty-one cases of atypical lesions were found. It was concluded that the presence of blood secretion should guide the surgical investigation.CrossRefGoogle Scholar

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Authors and Affiliations

  • BBSG – Brazilian Breast Study Group
    • 1
  1. 1.BBSGSao PauloBrazil

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