Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct
CPT4 code
Name of the Procedure:
Nipple Exploration, with or without Excision of a Solitary Lactiferous Duct or a Papilloma Lactiferous Duct
Summary
Nipple exploration is a medical procedure to examine and potentially remove one or more ducts within the nipple, particularly if suspicious growths or blockages like a papilloma are present.
Purpose
This procedure addresses abnormalities in the nipple, such as unusual discharge, duct blockages, or the presence of growths. The goal is to diagnose or treat underlying conditions, relieve symptoms, and prevent potential complications such as infections or cancer.
Indications
- Nipple discharge (especially if bloody or persistent)
- Palpable lumps or growths within the nipple
- Recurrent infections or inflammations in the breast
- Abnormal imaging findings during mammography or ultrasound
Preparation
- Fasting may be required if general anesthesia is used.
- Medication adjustments may be necessary (e.g., blood thinners should be paused).
- Pre-procedure diagnostic tests such as mammograms, ultrasounds, or biopsies might be conducted.
Procedure Description
- Anesthesia Administration: Local or general anesthesia is provided based on the case.
- Incision: A small incision is made in the nipple area.
- Exploration: The lactiferous ducts are explored using specialized surgical tools.
- Excision: If a papilloma or blockage is found, the affected duct is excised.
- Closure: The incision is closed with sutures.
Duration
Typically, the procedure takes about 30 minutes to an hour.
Setting
Performed in a hospital operating room or an outpatient surgical center.
Personnel
- Surgeons specializing in breast surgery.
- Nurses to assist during the procedure.
- Anesthesiologists if general anesthesia is administered.
Risks and Complications
- Infection
- Bleeding or hematoma formation
- Changes in nipple sensation
- Scarring
- Possible need for further surgery
Benefits
- Relief from symptoms such as abnormal nipple discharge.
- Accurate diagnosis of underlying conditions.
- Prevention of potential complications like infections or cancer.
Recovery
- Mild discomfort and swelling are expected; pain management will be provided.
- Keep the incision site clean and dry.
- Avoid heavy lifting or strenuous activity for a few days.
- Follow-up appointments for incision check and pathology results if tissue was removed.
Alternatives
- Observation and monitoring (watchful waiting).
- Non-surgical treatments if appropriate, such as antibiotics for infections.
- Imaging surveillance without immediate exploration.
Patient Experience
- Mild discomfort during recovery; pain is typically manageable with prescribed medications.
- Short-term limitations on physical activities.
- Most patients can return to normal activities within one week, depending on the extent of the procedure.