PERSISTENT BLOODY DISCHARGE AFTER MAJOR DUCT EXCISION

I had a major duct excision done in FEB05 for a unilateral, spontaneous bloody discharge from nipple on l. breast. (Had been ongoing since approx JUL04) Surgeon advised that a lesion was found, but it was result of ductal ectasia. I am a 43 year old non-smoker,never had children, and pre-menopausal. The bloody discharge persists, with discharge sometimes heavy enough to leave large stain that has soaked through nightclothes/sheet/mattress pad, and right through to mattress. The discharge is not constant and sometimes clear yellow. It is heaviest just before my period when my breast swells, and for 1 week after priod ends.  I also have continued pain in my left breast/armpit area, as had been prior to surgery.  My questions are: 1) Is it possible the duct ectasia found may not be the source of the blood?  2) Is it necessary to have this investigated further, since mammograms/ultrasound have been negative upto now?  I do not want to go through another surgery, as I had developed a bad infection after the first.  Also, I have concerns about any scar tissue in the breast that may be contributing to my current symptoms, and affecting future mammogram/ultrasound readings.

[CCF-RN,MSN-rf]

Dear roxymorr:  Duct ectasia is a widening and hardening of the duct. It usually affects women in their forties and fifties and can be characterized by thick green, black or clear nipple discharge. The nipple and surrounding tissue may be red and tender. Occassionally a hard lump can develop around the abnormal duct. Duct ectasia is usually diagnosed through physical examination and ultrasound, although additional testing may be recommended such as mammography, depending on the age of the woman. Duct ectasia may or may not need treatment. It may improve with heat application or antibiotics.
In some cases, the affected duct(s) can be surgically removed.
With respect to your questions, it is impossible for us to speculate on the source of the bleeding without reviewing your films, pathology report, and doing a physical examination.  You should discuss the continued discharge with your surgeon as he/she has your information and will be able to offer
recommendations as they pertain to your situation.  If you continue to be concerned, you might seek a second opinion with a breast specialist or even a breast surgeon.

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