An analysis of 270 patients undergoing microdochectomy for nipple discharge from a single identifiable duct, and without an associated lump, revealed that occult cancers were all accompanied by hemoglobin positive discharge. A simple method of detecting the presence of hemoglobin in the discharge is described. The incidence of cancer was found to be 5.9%. In order of frequency, intraduct papilloma, duct ectasia, cystic disease, and carcinoma accounted for over 90% of the cases. Six patients in whom no malignancy was seen in the microdochectomy specimen subsequently developed cancer in the ipsilateral breast. A close follow-up of all patients with hemoglobin positive discharge and in whom no cause for the discharge is demonstrated at microdochectomy is stressed
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