A 43-year-old G2P2 comes to your office reporting intermittent right nipple discharge that is bloody. She says the discharge is spontaneous and not associated with any nipple pruritus, burning, or discomfort. On physical examination, you do not detect any dominant breast masses, skin changes, or axillary lymphadenopathy.
Which of the following conditions is the most likely cause of this patient’s problem?
A. Breast cancerNipple discharge can occur in women with either benign or malignant breast conditions. Approximately 10% to 15% of women with benign breast disease complain of nipple discharge. Nipple discharge is present in only about 3% of women with breast malignancies. The most worrisome nipple discharges tend to be spontaneous, unilateral, and persistent. The color of nipple discharge does not differentiate benign from malignant breast conditions. The most common breast disorder associated with a bloody nipple discharge is an intraductal papilloma. However, breast carcinoma must always be ruled out in any patient complaining of a bloody nipple discharge. Sanguineous or serosanguineous nipple discharges can also be seen in women with duct ectasia and fibrocystic breast disease. Women with hyperprolactinemia caused by a pituitary adenoma experience bilateral milky white nipple discharges.