A 48-year-old woman reports recurrent serosanguineous discharge from a single duct of the right nipple. There is no palpable lump and mammography is normal. Cytology shows no malignant cells. What is the most likely diagnosis and appropriate next step?
- A Intraductal papilloma, microdochectomy of the affected duct ✓
- B Fibroadenoma, observe annually
- C DCIS, total mastectomy
- D Mammary duct ectasia, Hadfield's procedure
Correct answer: A. Intraductal papilloma, microdochectomy of the affected duct
Explanation
Single duct serous or serosanguineous discharge in this age group is classic for intraductal papilloma, a benign lesion arising close to the nipple. Even with benign cytology, surgical excision via microdochectomy is performed to exclude occult malignancy in the involved duct. Hadfield's cone excision is reserved for multiple duct discharge from duct ectasia, and mastectomy is unwarranted without evidence of carcinoma.
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.