A 34-year-old woman reports recurrent blood-stained discharge from a single duct of the right nipple. There is no palpable lump and mammography is normal. What is the most likely diagnosis?

• A Solitary intraduct papilloma ✓
• B Fibrocystic change
• C Duct ectasia
• D Fat necrosis

Explanation

B solitary intraduct papilloma is the commonest cause of blood-stained nipple discharge from a single duct in a young woman without a lump. It arises in the large subareolar ducts and bleeding follows torsion or pressure necrosis of its delicate stalk. Duct ectasia typically causes multicoloured, multiduct discharge in perimenopausal women, often with a subareolar mass or nipple retraction. Fibrocystic change and fat necrosis do not produce single-duct bleeding.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.