ReviewBJR open2019
Nipple discharge: The state of the art.
Review in BJR open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- ESR Essentials: diagnostic work-up in patients with symptomatic breast disease-practice recommendations by the European Society of Breast Imaging.European radiology · 2025Guideline
- Breast imaging and cancer diagnosis during the COVID-19 pandemic: recommendations from the Italian College of Breast Radiologists by SIRM.La Radiologia medica · 2020Guideline
- Assessing breast MRI image quality: the bMRI-QUAL scoring system.European radiology · 2026Article
- Extracellular vesicles in nipple discharge for breast cancer screening.Breast cancer research and treatment · 2026Article
- Bilateral Bloody Nipple Discharge in a Primigravid Patient: A Benign Presentation Mimicking Pathology.Cureus · 2026Article
- Development and validation of a clinical-bimodal nomogram to predict the malignancy of pathologic nipple discharge.Quantitative imaging in medicine and surgery · 2025Article
- Article
- Intraductal laser ablation during ductoscopy in patients with pathological nipple discharge.Breast cancer research and treatment · 2025Article
- An update on multimodal imaging strategies for nipple discharge: from detection to decision.Insights into imaging · 2025Article
- Clinical Characteristics and Independent Risk Factors for Pathologic Nipple Discharge of 375 Cases.The breast journal · 2025Article
- Advances in fibreoptic ductoscopy for the diagnosis and treatment of pathologic papillary overflow.Heliyon · 2024Review
- A retrospective study of ductoscopy combined with immediate methylene blue staining in nipple discharge diseases.Scientific reports · 2023Article
- The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography.Korean journal of radiology · 2022Article
- Article
- Diagnostic accuracy of breast MRI for patients with suspicious nipple discharge and negative mammography and ultrasound: a prospective study.European radiology · 2021Article
- Magnetic resonance imaging in the evaluation of pathologic nipple discharge: indications and imaging findings.The British journal of radiology · 2021Review
- DBT-galactography: a promising tool for improving the diagnostic workup of nipple discharge.European radiology experimental · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Over 80% of females experience nipple discharge during their life. Differently from lactational (milk production) and physiological (white, green, or yellow), which are usually bilateral and involving multiple ducts, pathologic nipple discharge (PND) is a spontaneous commonly single-duct and unilateral, clear, serous, or bloody secretion. Mostly caused by intraductal papilloma(s) or ductal ectasia, in 5-33% of cases is due to an underlying malignancy. After clinical history and physical examination, mammography is the first step after 39, but its sensitivity is low (7-26%). Ultrasound shows higher sensitivity (63-100%). Nipple discharge cytology is limited by a false negative rate over 50%. Galactography is an invasive technique that may cause discomfort and pain; it can be performed only when the duct discharge is demonstrated at the time of the study, with incomplete/failed examination rate up to 15% and a difficult differentiation between malignant and benign lesions. Ductoscopy, performed under local anesthesia in outpatients, provides a direct visualization of intraductal lesions, allowing for directed excision and facilitating a targeted surgery. Its sensitivity reaches 94%; however, it is available in only few centers and most clinicians are unfamiliar with its use. PND has recently emerged as a new indication for contrast-enhanced breast MRI, showing sensitivity superior to galactography, with an overall sensitivity up to 96%, also allowing tailored surgery. Surgery no longer can be considered the standard approach to PND. We propose a state-of-the art flowchart for the management of nipple discharge, including ductoscopy and breast MRI as best options.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.