Breast: nipple discharge: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Breast: nipple discharge

Sample item

A 38-year-old woman has spontaneous blood-stained discharge from a single duct of the right nipple. There is no palpable lump and ultrasound is normal. What is the most likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Intraductal papilloma

Spontaneous unilateral single-duct bloody discharge is most often due to a solitary intraductal papilloma in a large subareolar duct. Cytology and ductoscopy or ductography may help, and microdochectomy of the offending duct confirms the diagnosis and cures the symptom.

Option by option

  • A. Intraductal papilloma (correct)

    Correct. A papilloma in a major duct bleeds spontaneously from one orifice.

  • B. Fibroadenoma

    Fibroadenoma presents as a lump and does not cause nipple discharge.

  • C. Mammary duct ectasia

    Duct ectasia causes multi-duct, thick green or brown discharge in older women.

  • D. Prolactinoma

    Prolactinoma causes bilateral milky discharge from multiple ducts with amenorrhoea.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Intraductal papilloma. Spontaneous unilateral single-duct bloody discharge is most often due to a solitary intraductal papilloma in a large subareolar duct.

Why is "Fibroadenoma" not the answer?

Fibroadenoma presents as a lump and does not cause nipple discharge.

Why is "Mammary duct ectasia" not the answer?

Duct ectasia causes multi-duct, thick green or brown discharge in older women.

Why is "Prolactinoma" not the answer?

Prolactinoma causes bilateral milky discharge from multiple ducts with amenorrhoea.

What concept does this question test?

It tests Breast: nipple discharge in General Surgery. Cytology and ductoscopy or ductography may help, and microdochectomy of the offending duct confirms the diagnosis and cures the symptom.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Breast: nipple discharge?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.