Differential Diagnosis for Nipple Discharge
- Single most likely diagnosis
- Benign ductal ectasia: This condition is characterized by the dilation of the milk ducts, which can cause nipple discharge. The ultrasound findings of mild duct ectasia support this diagnosis.
- Other Likely diagnoses
- Fibrocystic changes: The mild prominence of the fibroglandular tissue in the retroareolar region could be indicative of fibrocystic changes, a common condition that can cause nipple discharge.
- Gynecomastia: Although the impression mentions "mild geynecostia," it is likely a typo, and gynecomastia (enlargement of breast tissue in males) could be a consideration, especially if the patient is male.
- Intraductal papilloma: A small papilloma within the duct could cause nipple discharge, although the ultrasound did not detect any masses.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Breast cancer: Although the ultrasound did not detect any masses or architectural distortion, breast cancer can present with nipple discharge, and it is essential to rule out this possibility.
- Papillary carcinoma: A subtype of breast cancer that can cause nipple discharge, often associated with intraductal papillomas.
- Inflammatory breast cancer: A rare and aggressive form of breast cancer that can cause skin changes, although the skin surfaces were reported as within normal limits (WNL) in this case.
- Rare diagnoses
- Ductal carcinoma in situ (DCIS) with nipple discharge: DCIS is a non-invasive form of breast cancer that can cause nipple discharge, although it is less common.
- Phyllodes tumor: A rare tumor that can cause nipple discharge, although it is more commonly associated with a palpable mass.
- Granulomatous mastitis: A rare inflammatory condition that can cause nipple discharge, often associated with other symptoms such as pain and skin changes.