FREQUENCY OF DUCT ECTASIA AND BREAST CANCER IN PATIENTS WITH NIPPLE DISCHARGE IN BMCH QUETTA

Abstract

Background: Nipple discharge is a common breast symptom ranging from benign conditions such as duct ectasia to serious malignancies like breast cancer. Differentiating between these causes is clinically important, as pathologic discharge—particularly bloody or unilateral—may indicate underlying malignancy requiring prompt diagnosis and management.

Objective: - To determine the frequency of duct ectasia and breast cancer in patient with nipple discharge in tertiary care hospital Quetta.

Methods: This was a cross-sectional study carried out in the Department of General Surgery, Bolan Medical Complex Hospital, Quetta, between February 1^st and May 31^st, 2025, under a non-probability consecutive sampling method. Women aged 25-60 years whose nipple discharge was intermittent within six months or less were considered included, whereas women with nipple trauma, abscess, past breast surgery, and blood disorders were excluded. All participants gave informed consent in writing. Demographic and clinical data like age, weight, height, and body mass index (BMI) were entered. A comprehensive history was recorded about the duration of nipple discharge, its nature, and other related symptoms, and a clinical examination was done to identify the discharge, lump, or any sign of infection. Diagnostic tests such as breast ultrasound, mammography, and biopsy were conducted to diagnose duct ectasia or breast cancer. The trained staff were expected to fill in data on a predesigned proforma, and inter-rater reliability tests were carried out to ensure the data were of quality and confidentiality.

Results: There were 118 women, including inpatients and outpatients, with intermittent episodes of nipple discharge included in the study. The mean age was 46.69 ± 7.15 years, the mean weight was 52.89 ± 7.25 kg, and the mean height was 154.86 ± 7.36 cm, corresponding to a mean BMI of 22.16 ± 3.46 kg/m². The mean duration of nipple discharge was 3.69 ± 1.60 months. Duct ectasia was identified in 37 women (31.4%), while breast cancer was diagnosed in 25 women (21.2%). Most participants had matriculation (35; 29.7%) or intermediate education (32; 27.1%), followed by graduates (27; 22.9%), secondary education (18; 15.3%), and primary education (6; 5.1%). Regarding socioeconomic status, 52 women (44.1%) were middle class, 38 (32.2%) lower class, and 28 (23.7%) upper class. Duct ectasia was more frequent in urban participants (29) compared to rural (8), showing a significant association (p = 0.032), while breast cancer was also higher in urban women (21 vs 4), with a significant association (p = 0.021). No significant relationships were observed between educational level (p = 0.834) or socioeconomic status (p = 0.369) and residence. The mean duration of nipple discharge did not differ significantly between patients with or without duct ectasia (3.65 vs 3.70 months, p = 0.863) or breast cancer (3.64 vs 3.70 months, p = 0.871). The age distribution showed trends toward higher frequencies in older age groups but was not statistically significant for either condition (duct ectasia p = 0.812, breast cancer p = 0.363).

Conclusion: The study gives essential information about the women suffering from nipple discharge in the tertiary hospital Quetta, where duct ectasia is the most prevalent benign etiology, and breast cancer is one of the pathologies that determine this phenomenon. The outcomes underscore the importance of careful screening of nipple discharge in every woman, particularly in urban communities and at advanced ages, to facilitate early diagnosis, proper diagnosis, and proper treatment of both benign and malignant.