
NIPPLE DISCHARGE
Many women will have during their lifetime
a nipple discharge. It can be either in one
breast or both. Most nipple discharge are not
serious. A clear nipple discharge is considered
normal and most of the time will not require
further work-up. If it persists or increases,
your physician will probably want to investigate
the matter further. A bloody nipple discharge
is different. Although most women with a bloody
nipple discharge will be found to have a benign
tumor inside one of the milk duct (intraductal
papilloma), it has to be proven. A bloody nipple
discharge can occasionally be the symptom of
a breast maligancy and should be thouroughly
investigated. Some surgeons will first order
a Galactrography which is an Xray of the ductal
system of the breast. This may help clarify
the cause of the discharge. Most of the time
a breast biopsy is warranted to obtain the diagnosis.
MALIGNANT BREAST LUMPS
Malignant lumps develop most often from mammary
ducts or lobules. Unlike benign lumps, malignant
lumps continue to grow in an uncontrolled manner
and in time, if left untreated, will spread
beyond the breast.
The basic structure of the breast is composed
of:
1) lobules, which when appropriately stimulated
will produce and secrete milk,
2) ducts, which carry the milk from the lobules
to a network of ducts and then eventually to
the nipple, and
3) supporting tissue : Breast cancer can arise
from each of these structures. The most common
site is the ducts, and secondarily is the lobules.
The terminology of ductal carcinoma and lobular
carcinoma is derived from the location of their
origin.
When breast cancer begins within the ducts of
the breast, this is referred to as intraductal
carcinoma in situ (DCIS), and it is considered
to be the earliest, detectable stage of breast
cancer. The most common progression of DCIS
is that it may, and in most cases, will become
an invasive carcinoma. It will go beyond the
duct into the breast tissue. Once this has spread
through the breast, it will spread to the lymph
nodes. From the lymph nodes it may spread to
other parts of the body, such as the bones,
lungs, liver or brain.
If the breast cancer originates in the lobules
of the breast it is called lobular carcinoma
in situ (LCIS). The evolution of this cancer
is similar to DCIS, but it has specific characteristics.
These characteristics are: |