Predictors of Malignancy for Female Patients with Suspicious Nipple Discharge: A Retrospective Study

Background: Suspicious nipple discharge (ND) in females requires further treatment, including biopsy or selective duct excision. It is important to identify predictors of malignancy in female patients with suspicious ND. Materials and Methods: This retrospective study included patients with suspicious ND who underwent surgical treatment at our center between January 2007 and December 2014. Clinicopathological features were compared between patients with and without malignancy. We used a Chi-square test and a logistic regression model as the univariate and multivariate analysis for identification of predictors of malignancy. Results: A total of 334 patients were eligible and included. The median age of the study population was 45 (range=19-81) years; 18.0% (60/334) of the entire study population had breast cancer. The univariate analysis suggested that older age (p=0.002) and presence of suspicious lumps (p<0.001) were significantly associated with malignancy. In contrast, presence of bloody discharge was not significantly associated with malignancy (p=0.324). The multivariate analysis confirmed that older age (p=0.023) and presence of suspicious lumps (p<0.001) were independent predictors of malignancy. For patients without suspicious lumps, we did not observe any association between the presence of bloody discharge and malignancy. For patients with suspicious lumps, tumor size was significantly associated with malignancy (p<0.001). Conclusion: Our study suggests that older age and the presence of suspicious lumps are predictors of the presence of malignancy in females with suspicious ND.

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