Clinical Characteristics and Independent Risk Factors for Pathologic Nipple Discharge of 375 Cases

TL;DR

This study examines 375 cases of pathologic nipple discharge to identify clinical characteristics and risk factors for different types of breast pathology.

Contribution

The study identifies age and discharge color as independent risk factors for breast cancer and precancerous lesions in patients with pathologic nipple discharge.

Findings

Age is a significant independent risk factor, with individuals over 45 more likely to have precancerous lesions or breast cancer.

Bloody discharge is associated with a higher incidence of breast cancer and precancerous lesions compared to non-bloody discharges.

Ductoscopy improves diagnostic rates for breast cancer and precancerous lesions.

Abstract

While the characteristics of pathologic nipple discharge (PND) are well documented in the literature, comparative clinical and risk factor analyses across different pathologic subtypes are lacking.

Medical records of patients with nipple discharge were retrospectively retrieved from an electronic medical record database and analyzed. In this study, 375 patients with a postoperative pathologically confirmed diagnosis of PND were included.

Age serves as an important independent risk factor for precancerous lesions and breast cancer, with the median age increasing alongside the severity of the pathology. Individuals under 45 years of age predominantly exhibited non-neoplastic and benign neoplastic lesions, whereas those over 45 were more likely to have precancerous lesions or breast cancer, with statistical significance (p < 0.01). Discharge color was a significant factor in distinguishing between different pathological findings (p < 0.01). Discharge color serves as an important independent risk factor for breast cancer. Bloody discharge was associated with a significantly higher incidence of breast cancer and precancerous lesions compared to non-bloody discharges. Upon dividing bloody discharge into brown and bright red for in-depth analysis, no significant difference was observed among the different pathological types (p > 0.05). Ductoscopy has a higher diagnostic rate for breast cancer and precancerous lesions (p < 0.01).

These results suggest the clinical characteristics of PND patients across four pathological types: non-neoplastic lesions, benign neoplastic lesions, precancerous lesions, and breast cancer, at the same time emphasizing the importance of age and discharge color as independent risk factors in the prognosis and management of nipple discharge.

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