Question
A 60-year-old lady comes with blood stained discharge from the nipple with family history of breast cancer. Next best step for her will be:
| A. |
Ductoscopy
|
| B. |
Sonomammogram
|
| C. |
Nipple discharge cytology
|
| D. |
MRI.
|
Show Answer
|
Correct Answer » D
Explanation
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|
Blood-stained nipple discharge is a pathological nipple discharge and may be caused by:
- Intraductal papilloma — most common cause
- Intraductal carcinoma
- Duct ectasia
According to the uploaded study material, in spontaneous blood-stained nipple discharge, ultrasonography (USG) is useful, while galactography is not essential.
Therefore, among the given options, sonomammography is the best next step.
Why not the other options:
- A. Ductoscopy: Can visualize intraductal lesions but is not the routine first investigation.
- C. Nipple discharge cytology: Has limited diagnostic sensitivity and a negative result cannot reliably exclude malignancy.
- D. MRI: Useful in selected high-risk women and for specific indications, but it is not the best initial investigation among these options. The family history increases suspicion but does not make MRI the immediate first choice in this clinical presentation.
