Monday 25 February 2013

Nipple discharge - 3

Diagnosis:
-          Physical examination.
-          Sample of discharge to examine for the evidence of infection or cancerous cells.
-          X ray of the breast (mammography).
-          Ultrasound.
-          Blood sample to measure hormonal levels.
-          Brain scan.
-          Surgical excision and analysis of one or more ducts in the nipple.


Management :

-          If caused by normal hormonal changes it will be usually harmless and does not       require treatment.
-          Repeated squeezing should be avoided as that can increase the discharge.
-          Galactorrhoea:  drugs like cabergoline (doapamine 2 receptor agonist) which will reduce the production of prolactin from pituitary gland can be used.
       Bromocriptine (all dopamine receptors agonist but very strong D2 agonist) also serves the purpose.
      Pyridoxin (vitamin B6) also helps in treating galactorrhea.
-          Pus discharge can be treated with antibiotics.
-          Blood stained discharge due to non-cancerous tumor can be treated by surgical removal of that particular duct.
-          Malignant tumors need surgery and radiotherapy. Radiation can possibly destroy any remaining cancerous cells after surgery.

Features
Causes
Diagnosis and management 
Self examination of breast



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