NONPALPABLE BREAST-CANCER WITH NIPPLE DISCHARGE - HOW SHOULD IT BE TREATED

In this study, 26 cases of nonpalpable breast cancer with nipple disch arge treated at our department were reviewed. Their discharge was eith er bloody or serous with a positive hematest, but all except for one w ere negative for cytology, while CEA value of the discharge was high i n 72.7%. Mammograms were found to be unreliable for diagnosis, while a bnormal findings were observed in 84.6% by ductography. However, final diagnosis was determined histopathologically from surgical specimens, showing 14 intraductal and 12 invasive ductal cancers, none with comp onents of comedo carcinomas. Seventeen patients underwent mastectomy f ollowing duct-lobular segmentectomy and a small remnant of intraductal carcinoma was found microscopically in only one patient. All patients except for one have survived for 98 months on average with no symptom s of metastasis. These findings suggest that duct-lobular segmentectom y with an adequate surgical margin should be adopted as the final oper ation for selected patients with nonpalpable breast cancer involving n ipple discharge.