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, and it is a common cause of nipple discharge.
Other Likely Diagnoses
- Intraductal papilloma: A small, benign tumor that grows in the milk ducts, which can cause nipple discharge. Although no solid mass was found on the ultrasound, intraductal papillomas can be small and may not always be visible.
- Gynecomastia: The ultrasound impression mentions mild gynecomastia, which can cause nipple discharge in men. However, gynecomastia is more commonly associated with breast tenderness and swelling.
- Fibrocystic changes: These are non-cancerous changes in the breast tissue that can cause nipple discharge. The ultrasound findings of mild prominence of the fibroglandular tissue support this diagnosis.
Do Not Miss Diagnoses
- Breast cancer: Although the ultrasound did not show any masses or architectural distortion, breast cancer can present with nipple discharge. It is essential to rule out breast cancer, especially if the discharge is bloody or unilateral.
- Papillary carcinoma: A type of breast cancer that can cause nipple discharge. Although rare, it is crucial to consider this diagnosis to avoid missing a potentially life-threatening condition.
- Ductal carcinoma in situ (DCIS): A pre-invasive form of breast cancer that can cause nipple discharge. DCIS can be difficult to detect on ultrasound, and a biopsy may be necessary to rule out this condition.
Rare Diagnoses
- Galactorrhea: A rare condition characterized by the spontaneous flow of milk from the breast, which can cause nipple discharge. This condition is often associated with hormonal imbalances or certain medications.
- Syringomatous adenoma of the nipple: A rare, benign tumor that can cause nipple discharge. This condition is often difficult to diagnose and may require a biopsy to confirm.
- Nipple adenoma: A rare, benign tumor that can cause nipple discharge. This condition is often associated with a palpable mass, which was not found on the ultrasound.