GP Liaison Website
GP Liaison Website Now Live
half of these cases, women become aware
of the discharge as a result of expressing
the breast (non-spontaneous) and with
others awareness occurs spontaneously. In
addition, nipple discharge can be unilateral
or bilateral and from one or multiple ducts.
There are several types of nipple discharge:
• Pseudo Galactorrhoea
• Blood-related nipple discharge:
serous, sero-sanguinous, sanguinous
Although nipple discharge is a common
breast symptom it is not usually a
manifestation of breast cancer. Only
spontaneous blood-related nipple
discharge is found to be associated with
breast cancer albeit in a minority of these
cases, amounting to approximately 10%
with wider range in relation to age at
presentation.The correlation of blood-
related nipple discharge and breast cancer
increases with age. Nipple discharge
is considered pathological when it is
spontaneous, blood-related and from a
single duct from one breast. Clinical
examination rarely reveals any other
physical findings and therefore further
investigations are required to exclude
underlying breast cancer.
Over 50% of cases are Carcinoma In-Situ
(CIS) with the presence of a breast lump
in association with blood-related nipple
discharge increasing the probability of an
underlying invasive disease.
Several investigative methods have
been used in determining a prognosis.
Cytological examination of the discharge
has proven unhelpful, with frequent false
negative and false positive results. Imaging
of the breast using ultrasound scan and
mammography are frequently employed,
where appropriate, with ultrasound
scan helpful in identifying retroareolar
intraduct pathology, such as a papilloma.
Mammography is usually used in women
35 years and over to visualise non-palpable
soft tissue masses or microcalcifications
that require preoperative tissue diagnosis.
The new technology of intraduct
microendoscopy is still in its infancy and it is
too early to rely upon.
Diagnosis of underlying pathology is
unequivocally achieved by surgical excision
of the offending duct, Microdochectomy.
Benign Intraduct Papillomata are the
most frequently encountered pathology.
Duct-ectasia and Fibrocystic changes
are common, however, breast cancer
represents a small percentage of the
London Bridge Hospital’s GP Liaison website went live
early in 2010 providing another useful resource for
GPs.The site provides information on upcoming GP
Seminars and on members of the GP Liaison Team.
London Bridge Hospital’s Marketing and GP Liaison
Manager, Manuela Bernhard, says,“The launch of the
GP Liaison website will play an important role in
continuing to make information and seminar details
as accessible as possible for GPs.We are constantly
looking for new ways to make life as easy as possible
for GPs, given their busy schedules, and now we have
another channel through which to do that.”
If you would like to visit the GP Liaison website, please
Is it Commonly a Sign
of Breast Cancer?
The breasts are developmentally
modified sweat glands. In addition to their
predominant function of milk production
at the end of pregnancy, breasts can
produce secretions of various colours
and consistencies which are considered
a part of their physiological function.
However, nipple discharge could also
occur as a result of local breast changes
or underlying pathology.Women will often
seek consultation for nipple discharge for a
variety of reasons, including inconvenience
or embarrassment, as a part of other
breast problems such as pain or a lump,
and, most significantly, through a fear of
Nipple discharge constitutes about 7% of
all cases referred to breast clinics. In over
Often patients of mine experiencing nipple discharge
will come to me with concerns regarding the correlation
between nipple discharge and breast cancer.
Mr Hisham Hamed
MB BCh PhD FRCS
Consultant Breast Surgeon
T: 020 7403 7672