Cytological Evaluation of "Bloody" Nipple Discharge with Histopathological Correlation: Study of 50 Cases.
Rachel E Kaplan, Syed A Hoda, Rana S Hoda. Weill Cornell Medical College, New York, NY
Background: Nipple discharge can be serous, milky, mucoid, turbid or bloody. Bloody nipple discharge (BND) is particularly alarming, and is considered most likely to be associated with a pathological (rather than physiological) cause. Data on BND cytology (BNDC) with histopathological correlation is scarce.
Design: Excisional biopsies (including micrdochectomies), 2000-to date, submitted with BND as clinical information, and in which there had been prior BNDC were identified and reviewed. Cytological evaluations were classified as Positive (Pos), Papillary (Pap), Atypical (Aty), Negative (Neg) or Unsatisfactory-Acellular (Unsat).
Results: 50 cases with 55 BNDC (5 cases with 2 specimens <8 months apart) were studied. Mean age of patients was 50 (range: 14-87). BND was unilateral in all 50 patients (right: 28, left: 22). Histopathology diagnoses were invasive carcinoma (Inv Ca): 5; ductal ca in situ (DCIS): 5; atypical hyperplasia (Aty): 2; papilloma: 16 (32%, single most common cause of BND); other benign (Oth): 22. In 4 BNDC cases, the 1st specimen was Unsat or Neg. In 1 case, both BNDC were Pap. Final cytology diagnoses were Pos: 3; Pap, 13; Aty: 4; Neg: 25; and Unsat: 5.
|Invasive Ca||DCIS||Atypical||Papilloma||Other||Total, on Cytology|
|Total, on Histopathology||5||5||2||16||22||50|