Objective  The clinical and pathological features and the follow-ups of 173 patients with pathological nipple discharge were analyzed to provide the basis for diagnosis and treatment.

  Methods  We reviewed the data of the patients who suffered from pathological nipple discharge and as well underwent surgery in Peking Union Medical College Hospital from Jan to Dec 2015. According to the characteristics of nipple discharge, the patients were divided into groups of hemorrhagic and non-hemorrhagic nipple discharge. We compared the clinical and pathological characteristics between the two groups.

  Results  A total of 173 patients who met the inclusion and exclusion criteria were enrolled in this study, all of whom were female, with an average age of (45.65±13.48)years and a median course of disease of 3(1, 12)months. Among them, 119 patients (68.8%, 119/173) had hemorrhagic discharge; 54 patients (31.2%, 54/173) had non-hemorrhagic serous discharge. 111 patients (64.2%, 111/173) had lesions detected by ultrasound before surgery. Therewas no significant difference in age, course of the disease, preoperative physical condition, molybdenum target examination results, and the postoperative pathological classification between the two groups (all P>0.05). There were statistically significant differences in preoperative ultrasound examination (whether lesions were found) and postoperative pathological diagnosis (whether breast cancer was found) (P=0.012 and P=0.045). The age of the malignant lesion group was older in patients with hemorrhagic discharge (P=0.014). After a median follow-up of 17 (14, 20) months, none of the patients who were diagnosed with breast cancer had a recurrence, metastasis, or deceased.

  Conclusions  Hemorrhagic nipple discharge showed a higher risk of breast cancer, especially for elder patients. Ultrasound revealed more lumps than physical examination and mammography. Since the examinations can not identify the malignant lesions out of the symptoms of nipple discharge, surgery is always needed and the postoperative prognosis is quite good.