Confused about surgery (papilloma)

Ah262

In June I found a lump in my breast. I had a mammogram/ultrasound/biopsy and was found to be a simple fibroadenoma. Great.

I saw a surgeon after and she was all ready to end my appointment when she asked if I had any nipple discharge. I told her I did... during my initial mammogram I had a lot of bloody/brown discharge on the mammogram slide. I thought it was normal! Ever since then I’ve had the occasional stained spot in my bra. She became concerned and took a sample and it tested positive for blood. She ordered another ultrasound to look for anything near the nipple. That came back as clear... all the radiologist said was that I have a lot of little cysts in the ducts but that was common.

That same evening the surgeon callled and said she wanted to do surgery. I asked her what she would do surgery on since there was nothing showing on the ultrasound and she said something about putting a tube in the nipple and cutting near the areola to take out what was in there. I’m still confused as to what she would take out if there was nothing on the imaging. Any ideas? I’m not too keen on the idea of surgery. Should I ask for an mri beforehand? I go back to see her on sept 4t

mountainmama406

My whole adventure started as hoping it was just a papilloma. I had surgery to remove and test the area showing up. My surgeon and I agreed that getting and testing it all would be the only way to know what it was and wasn't. I also wanted my discharge to stop so that was a benefit of going in to clear it all out (if my news had been better). That surgery and the recovery was pretty simple. After test results from that is when I did my MRI to help decide on lumpectomy vs mastectomy. I’m not sure if there’s a particular order things have to happen in, if you wanted the MRI first — if it was cancer there’s a higher chance of multiple surgeries anyhow??

CindyNY

Ah262- I had a breast MRI prior to surgery. From what I've discovered here, not everyone does. My ob/gyn had it approved by my insurance, and ordered prior to meeting my surgeon. They check both breasts with MRI. If your insurance will cover it, I'd opt for it. Best of luck to you.

djmammo

Ah262

I have never seen cysts in ducts. Are you sure thats what they said? Did they say bubbles? Debris?

The surgeon was talking about removing the duct that has been producing the discharge. Even though you can't see it on imaging, there is something there bleeding in the duct which could be benign or malignant.

The procedure with the tube they were describing is the following: once in the OR with you asleep or sedated, a thin blunt cannula is inserted into the duct that is producing the discharge. A blue dye is then injected. When the surgeon dissects down to the level of the ducts they will see that one of the ducts is blue and they will remove it and hopefully with it the cause of the discharge.

Ah262

thank you all for responding. I’ll ask about an mri, I think my insurance will cover it but needs to be approved first.

I think what I was confused about most was why she would do surgery without seeing anything on the imaging but it sounds like that doesn’t really mean that nothing is there, right?

Djmammo, yes she said there were lots of little cysts. Maybe it was something else but she was just trying to describe it in terms I might understand better?

djmammo

Ah262

I think what I was confused about most was why she would do surgery without seeing anything on the imaging but it sounds like that doesn't really mean that nothing is there, right?

The discharge indicates something is there in the duct, you can assume that without seeing it. Before CT people had their appendix removed when inflamed based on symptoms and physical exam, without seeing it. Classic symptoms. Same here. The blue dye is used to indicate where it is as described above.