Management of nipple discharge

management of patients with nipple discharge

If any red flag symptom is identified during history and physical examination, urgent referral to a breast clinic for review within two weeks is recommended.

If an endocrinopathy is suspected (e.g. - prolactinoma or hypothyroidism), investigate the serum prolactin and thyroid stimulating hormone levels.

NICE suggest urgent referral if:

• nipple changes of concern (in one nipple only) including discharge and retraction, in patient 50 and over

Specialist advice should be sought if nipple discharge in patients less than 50 years old (unless obviously a physiological cause)

• urgent referral is indicated if any red flag features

Reference:

• (1) Labib PL, Gallegos N, Hegarty D. Nipple discharge. BMJ. 2015;351:h3123.
• (2) NICE (June 2015). Suspected cancer: recognition and referral