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GP Liaison Website

GP LiaisonWebsite

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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:

• Galactorrhoea

• Pseudo Galactorrhoea

• Opalescent

• Blood-related nipple discharge:

serous, sero-sanguinous, sanguinous

and watery.

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

cases treated.

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

go to:

www.gpseminar.co.uk

Nipple Discharge:

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

breast cancer.

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