Nipple Discharge

Availability

North South North West Statewide

Pre-referral work-up

History

All women aged 55 and over with nipple discharge should be referred, in addition to women under 55 with:

  • Bilateral discharge sufficient to stain clothes
  • Blood stained
  • Persistent single duct

All referrals should comply to referral standards and also include:

  • Onset of discharge
  • Nature of discharge – blood, colour, odour
  • Lactation history
  • Clinical examination – description of breast, nipple and discharge

Tests

  • Consider swab +/- cytology if appropriate
  • Mammography if over 35, or under 35 with abnormal findings on examination
  • Ultrasound if unilateral or blood-stained

Interim/GP management

To refer a patient with this condition, please see the Breast Surgery clinic page for the full referral process and templates.

Simple analgesia if required.

For more information please see the Tasmanian Health Pathways website.

Routine / category 3

Discharge with normal examination and investigations

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

http://canceraustralia.gov.au/clinical-practice-guidelines/breast-cancer

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment