Nipple discharge/ duct excision

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NEbucks
NEbucks Member Posts: 3
edited September 2016 in Waiting for Test Results

Hello all, I've been lurking for several weeks and could not be more thankful for the information I've received. I could use a little guidance.

I'm 34, no family history whatsoever. Three weeks ago I had spontaneous frank bloody discharge from my right nipple when I was getting dressed. I was able to squeeze a bit more out that evening, none after.

Over the next two weeks I had a mammogram, two US and a breast MRI. All negative for anything suspicious in the right where I had the discharge. They did, however, find a 1.8 cm spiculated mass on the left with architectural distortion and microcalcifications. I underwent vacuum assisted stereotactic biopsy with benign pathology. This was thought to potentially be discordant and I'm having an excisional biopsy next week.

After discussing all that with the breast surgeon, we circled back to the nipple discharge which was my original symptom and reason for referral in the first place. With A LOT of manipulation she was able to express a little clear fluid. This was guaiac positive for occult blood. She recommends ductoscopy when I'm in the OR next week. However, if unable to reproduce the drainage, wants to do a surgical duct excision. This would be a peri-aerolar incision and also potentially affect my chances of breastfeeding in the future (single, would like to have children). My other option is to watch and wait.

I, of course, want to make the right decision. Considering that I only had one episode of discharge and it is not persistent, and have had negative imaging, am a little cautious to have duct excision surgery. I'm okay having the ductoscopy. I ran this pastthe breast radiologist who did my breast biopsy and she thought that was reasonable. I will be having a repeat MRI in 6 months anyway to follow a fibroadenoma on the left. This is also, of course, assuming that my final pathology on my breast mass remains benign.

So, long story short, would you all be comfortable waiting if the ductoscopy is unable to be performed? If I have recurrent discharge, then I would absolutely proceed with surgical duct excision. Anyone have any experience with this?

Thanks!

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Comments

  • Lovinmy6
    Lovinmy6 Member Posts: 3
    edited August 2016

    He there NEbucks. About 6 years ago I had the same thing happen to me. I was nervous so I met with the nurse practitioner at my OB office. I was able to express a small amount of bloody discharge at home but when I got to the office we couldn't get anymore. I had just finished nursing my daughter a few months prior so she said it was probably something to do with that. I went on my way with no further testing. Then in May of 2013 I noticed a small amount of blood on my bra. I called my OB the next day and they got me in that afternoon. My Dr was able to express discharge but was unable to feel any lumps. I was 33 at the time so he thought it wasn't anything major but wanted me to have it checked out anyways. I had a mammogram and an ultrasound where they saw two suspicious spots. I had a core needle biopsy and I was diagnosed with High Grade DCIS in both spots. If you're thinking of opting out of some testing just make sure your Dr is following you and keeping an eye on your breasts. Good luck to you

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  • Moderators
    Moderators Member Posts: 25,912
    edited August 2016

    Hi NEbucks, we hear you, and wanted to welcome you to our community here at BCO. We know you're going through a scary and uncertain time, but just know that you are not alone! Hope you get responses from other caring and informed members soon like Lovinmy6. And please, let us know how you're doing!

    The Mods

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  • NEbucks
    NEbucks Member Posts: 3
    edited August 2016

    Thanks for sharing your experience Lovinmy6. It was a good thing you were so diligent about your symptoms.

    I called the surgeon's office today and we left it that I'll be getting a ductoscopy with possible excision based on results, but will hold on a major duct surgicalexcision if unable to technically do the ductoscopy. I don't feel 100% about my decision but feel more confident then the other way around.

    Of course I will have a very low threshold for revising the idea of surgery if I have any further drainage or symptoms.

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  • Clairen
    Clairen Member Posts: 22
    edited August 2016

    I had a total duct removal from one breast yesterday based on blood from one duct. Thankfully ive finished having kids and breastfeeding but had i not, im not entirely sure what id have done. If they can catheterise the one duct you can still feed but i believe that's quite tricky. If you do end up having the op im one day post op (so dont want to speak too soon) and surprised at how little pain im in.

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  • NEbucks
    NEbucks Member Posts: 3
    edited September 2016

    Clairen, thanks for the feedback. How does you incision look? Can you tell that they took a lot of tissue out with the total duct excision?Were you having continuous discharge or just isolated?

    I'm not against having surgery, I just don't want to be overly aggressive. However, since I made my decision not to I am so anxious about every little twinge. I'm afraid now that I'm just going to be a nervous wreck about the "what ifs" and wonder if I should just get it done for peace of mind.

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  • Clairen
    Clairen Member Posts: 22
    edited September 2016

    Hi! I totally get where you are coming from. I'm very much into considering alternatives and end up researching everything but it really didn't seem like there was any alternative and i know im incapable of not knowing..

    Anyway, to answer your question my dressing is still on so no idea what its like uunder there but i have a few pics i could somehow get to you. If you are on facebook i could send them across in a pm? Im not sure how to do it on here.

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