If there is a bloody discharge with a palpable mass, what is recommended?

If there is a bloody discharge with a palpable mass, what is recommended?

• A. Observation
• B. Excision of the involved duct and mass
• C. Chemotherapy
• D. Radiation therapy

Answer: (B)

Bloody discharge with a palpable mass points to an intraductal process, such as an intraductal papilloma or a malignancy, and requires tissue diagnosis plus removal of the abnormal tissue. The best step is to surgically excise the involved duct along with the mass (a targeted duct excision or microdochectomy). This approach both cures or reduces symptoms and provides a definitive pathology to determine whether the lesion is benign or malignant. Observation would miss a potential cancer and allow ongoing discharge. Chemotherapy or radiation are not initial management for a localized ductal lesion presenting this way; they are reserved for established cancer or systemic disease after a proper diagnosis.

Bloody discharge with a palpable mass points to an intraductal process, such as an intraductal papilloma or a malignancy, and requires tissue diagnosis plus removal of the abnormal tissue. The best step is to surgically excise the involved duct along with the mass (a targeted duct excision or microdochectomy). This approach both cures or reduces symptoms and provides a definitive pathology to determine whether the lesion is benign or malignant.

Observation would miss a potential cancer and allow ongoing discharge. Chemotherapy or radiation are not initial management for a localized ductal lesion presenting this way; they are reserved for established cancer or systemic disease after a proper diagnosis.