Current management of nipple discharge

Nipple discharge is a relatively common complaint, with the primary concern being an underlying breast carcinoma. The difficulty in managing nipple discharge is that the risk of carcinoma, despite being low, cannot be eliminated without surgical duct excision and histologic confirmation. In the following chapter, the evidence for the risks and benefits of the most common diagnostic tests within defined clinical circumstances is examined critically, and a structured, evidence-based algorithm is presented. Using such a systematic approach to nipple discharge allows the clinician to stratify patients with pathologic nipple discharge into low- and high-risk groups. Low-risk patients can be safely offered close clinical follow-up rather than subjecting all patients with pathologic discharge to operative intervention and additional expensive tests.