Medical Council of Canada

Medical expert

Breast Discharge - 10-2

Rationale

Although noticeable breast secretions are normal in most reproductive-aged women, spontaneous persistent discharge may reflect underlying disease and requires investigation.

Causal Conditions

(list not exhaustive)
  1. Galactorrhea
    1. Idiopathic
    2. Hyperprolactinemia
      1. Physiologic
      2. Drugs, including herbal remedies
      3. Pituitary tumors
  2. Breast neoplasm

Key Objectives

Given a patient with breast discharge, the candidate will diagnose the cause, severity, and complications, and will initiate an appropriate management plan, with emphasis on differentiating between galactorrhea and other causes of breast discharge.

Enabling Objectives

Given a patient with breast discharge, the candidate will

  1. list and interpret critical clinical findings, including
    1. examination of breasts for skin lesions;
    2. charactistics of discharge;
    3. breast mass;
  2. list and interpret critical investigations and laboratory findings, including
    1. diagnostic cytology;
    2. diagnostic imaging;
  3. construct an effective management plan and determine appropriate follow-up, including
    1. counsel/educate the patient (e.g., possible fear of cancer);
    2. determine if the patient requires specialized care.
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