Ill massage your breasts with my mouth

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NCBI Bookshelf. Karima R. Authors Karima R. Nipple discharge is fluid that leaks from one or both nipples of non-pregnant and non-breastfeeding women. Nipple discharge can at times be a complex diagnostic challenge for clinicians since it can be completely benign and due to excessive Ill massage your breasts with my mouth stimulation, or can be a manifestation of a wide variety of diseases. With heightened public awareness of breast cancer, an increasing of women are asking their health care providers about nipple discharge.

Thus, clinicians must be knowledgeable regarding the best practices for evaluating nipple discharge. This activity reviews the causes of nipple discharge and highlights the role of the interprofessional team in its workup and management. Objectives: Identify the etiology of nipple discharge. Describe the presentation of a patient with nipple discharge. Explain the workup for a patient with nipple discharge. Describe how an optimally functioning interprofessional team would coordinate care to enhance outcomes for patients with nipple discharge and their families.

Any fluid that leaks from one or both nipples of a non-pregnant and non-breastfeeding breast is referred to as nipple discharge. Nipple discharge is a complex diagnostic challenge for the clinician as it can occur normally or be a manifestation of a wide variety of diseases. Each human breast has 15 to 20 milk ducts.

Nipple discharge can originate from one or more of these milk ducts. The most important consideration in a patient with nipple discharge for both the patient and the physician is the possible association of this condition with underlying breast cancer. With the increased public awareness of breast cancer, an increasing of women are asking their health care providers about nipple discharge. Thus, a clinician must be aware and knowledgeable in evaluating nipple discharge. Nipple discharge Ill massage your breasts with my mouth not an uncommon complaint in the emergency department and can be benign physiologic discharge or a of a pathologic process.

Nipple discharge is normal during the last few weeks of pregnancy, after childbirth, and during the breastfeeding period. It can also be normal in women who are not pregnant and are not breastfeeding, especially during reproductive years. Certain manipulations of the breasts, such as fondling, sucking, or massaging can stimulate milk ducts to secrete fluid.

Stress also has been shown to cause nipple discharge. Nipple discharge in men is always abnormal and also must prompt an evaluation. Nipple discharge is the third most common breast complaint after breast pain and breast mass. The clinical history is most helpful in distinguishing benign from suspicious or pathologic nipple discharge.

The patient's age is very important, as women greater than 40 years of age are at higher risk of having pathologic discharge. Postmenopausal women with nipple discharge are rarely benign. History of present illness should include the onset of discharge, association with the menstrual cycle, persistence, and the character and color of the discharge. A patient's reproductive history is important e. Other relevant histories, including a history of any breast problems, including breast biopsies, and surgical history e. Medications history is of paramount importance, as many medications can cause nipple discharge as a side effect.

One must not miss the presence of fever mastitis or breast abscesssymptoms of hypothyroidism weight gain, cold intolerance, constipation, amenorrheasymptoms of liver disease ascites, jaundiceand symptoms of a pituitary tumor visual changes, amenorrhea, headache to narrow down the differential diagnosis of nipple discharge. The patient should be examined for the presence of any breast masses, asymmetry, and skin changes. After the inspection, palpation should include all four quadrants of each breast and bilateral axillae, supra- and infraclavicular areas to look for masses, swelling, tenderness, and lymphadenopathy.

If no spontaneous discharge is visible, the examiner should attempt to extract the discharge by applying even pressure from the periphery toward the nipples so-called, pressure point exam. Physiologic discharge is usually bilateral, with clear fluid, involves multiple ducts, and is non-sticky. Pathologic discharge is usually unilateral, spontaneous, varied in appearance, and depending on the cause, involves a single duct. Abnormal discharge is frequently associated with other abnormalities, such as a mass, swelling, redness, dimpled skin, or retracted nipple.

Those patients, whose age, history, and physical examination suggest the benign cause of their discharge, may be reassured and discharged with outpatient follow-up at their primary care provider's office. However, in patients at high risk for a pathologic process as a cause of their discharge or with worrisome history and physical examination, urgent follow-up with a breast surgeon must be sought. The first step in the evaluation of breast discharge is to rule out whether the discharge is physiological or pathological. Physiological discharge is bilateral and is clear or milky.

Ill massage your breasts with my mouth

Pathological discharge is always unilateral and may be bloody. It is hence important to note the color of discharge, whether it occurs spontaneously or occurs with stimulation which is physiological. Also, associated symptoms are interpreted to make the final diagnosis. For patients with physiological discharge, TSH levels, and prolactin levels are measured to rule out systemic causes of nipple discharge. For patients lesser than 40 years of age, routine observation is required.

For patients greater than 40 years of age, mammography is indicated. If abnormal, a breast biopsy is performed. If normal, then breast MRI, or surgical excision of the lump if an associated lump is present is done. Fluid cytology can also be Ill massage your breasts with my mouth to study the malignant cells in patients with blood discharge, where breast cancer is suspected. In case of a suspected or obvious breast abscess when emergent ultrasound of the breast and a general surgery consultation are needed in the emergency department.

Depending on the of the breast ultrasound and evaluation of the general surgery consultants, the patient may or may not be taken to the operating room for incision and drainage of an abscess. Therefore, appropriate anesthesia is needed, possibly in the operating room, to minimize pain and suffering in a patient, as well as aesthetic considerations. The treatment of breast discharge depends on the Ill massage your breasts with my mouth.

A physiological discharge does not require any treatment. Systemic causes of nipple discharge require specific medications. Benign causes of breast discharge like duct ectasia requires microdochectomy removal of one duct or total duct excision removal of all ducts. Duct papillomas that produce unilateral bloody discharge require microdochectomy. Purulent discharge is treated with appropriate antibiotics, but abscesses need incision and drainage and wall biopsy of the abscess.

Most nipple discharge is due to an intraductal papilloma and these patients have an excellent outcome when the lesion is excised. The nurse, the clinician, and the pharmacist play a pivotal role in educating patients with nipple discharge and their families about their condition. The interprofessional team should ensure that patients are given the necessary information about their condition and the available treatment options. A clear and open discussion about the goals of their care plan and any available alternatives.

The nurse should provide patients with written information leaflets about their condition and refer them, if available, to educational websites that will enhance their understanding of their disease. Nipple discharge is best managed by an interprofessional team, including nurse practitioners.

However, it is important to be aware that not all nipple discharge is benign. In some cases, a mass may be present, and further workup to rule out malignancy is recommended. The nurse has a crucial role in addressing the concerns of patients with women discharge, as this diagnosis could carry a tremendous negative emotional impact on patients and their families. The nurse assists the clinician in counseling these women and responding to their concerns throughout the journey of their management.

The nurse carefully observes the characteristics of the nipple discharge and makes sure to document the findings in the patient's medical records. Breast care and radiologic specialty trained nurses are often involved in the coordination of care. The nurse should report any untoward changes in the vital s of the patient to the clinician. The nurse should communicate with other members of the interprofessional team to ensure the optimal standard of care to their patients. This book is distributed under the terms of the Creative Commons Attribution 4.

Turn recording back on. National Center for Biotechnology InformationU. StatPearls [Internet]. Search term. Breast Nipple Discharge Karima R. Author Information Authors Karima R. Affiliations 1 Drexel University College of Medicine. Continuing Education Activity Nipple discharge is fluid that leaks from one or both nipples of non-pregnant and non-breastfeeding women.

Introduction Any fluid that leaks from one or both nipples of a non-pregnant and non-breastfeeding breast is referred to as nipple discharge. A side effect of medications that inhibit dopamine secretion e. Epidemiology Nipple discharge is the third most common breast complaint after breast pain and breast mass. History and Physical The clinical history is most helpful in distinguishing benign from suspicious or pathologic nipple discharge. Differential Diagnosis Intraductal papilloma. Prognosis Most nipple discharge is due to an intraductal papilloma and these patients have an excellent outcome when the lesion is excised.

Deterrence and Patient Education The nurse, the clinician, and the pharmacist play a pivotal role in educating patients with nipple discharge and their families about their condition. Enhancing Healthcare Team Outcomes Nipple discharge is best managed by an interprofessional team, including nurse practitioners. Comment on this article. References 1. Santen RJ. Benign Breast Disease in Women. Endotext [Internet].

Ill massage your breasts with my mouth

A simple approach to nipple discharge. Am Surg. Frequency of diagnosis of cancer or high-risk lesion at operation for pathologic nipple discharge.

Ill massage your breasts with my mouth

Sakorafas GH. Nipple discharge: current diagnostic and therapeutic approaches. Cancer Treat Rev. Common benign breast concerns for the primary care physician. Cleve Clin J Med. Evaluating nipple discharge. Obstet Gynecol Surv. Leis HP. Management of nipple discharge. World J Surg. Surgical management of nipple discharge. Eur J Gynaecol Oncol. Microdochectomy for single-duct nipple discharge. Ann Acad Med Singap. Breast Nipple Discharge.

Ill massage your breasts with my mouth

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