A blood stained discharge from the nipple indicates

(Duct papilloma) (831 - Baity & Love 25th, 281- CSDT 13th)Blood discharge from nipple caused by benign papilloma in the ductCauses of blood stained discharge from nippleBlood stained discharge from a single ductMore than one duct,* Intraductal carcinoma* Intraductal papilloma*** Duct ectasia* Carcinoma* Ectasia* Fibrocystic diseaseCauses of other tvpe of discharge from nippleSerous (any colour)Grumous/GramPurulentMilk* Fibrocystic disease* Duct ectasia* Carcinoma* Duct ectasiaInfections* Lactation* OCP users* Estrogen replacement therapyGreenish discharge is seen in fibroadenosis and mammary duct ectasia* Treatment of ductal papilloma (<40 years) - Michrodochectomy*** Lobular carcinoma are associated with bilaterality, A biopsy of the contralateral breast is therefore requiredCEA is a marker of Paget's disease of the mammary gland (Infiltratina ductal carcinoma)Post radical neck dissection syndrome - arising from denervation and atrophy of the trapezius muscle due to sacrifice of the spinal accessory nerve (SAN)- Inability to abduct the shoulder beyond 90deg cephalad- Long standing pain in the shoulder- Deformity of the shoulder girdle- Drooping of the shoulder, shoulder abduction and external rotationCauses of Fat necrosis1. After surgery / surgical trauma -* Wide local excision* Reduction mammoplsty*** Breat reconstruction* Breast biopsy2. Following radiotherapy* including iridium implant3. following trauma4. Autologous fat injection using the liposuction* technique to fill in irregular contours & small soft tissue defects in the breast may lead to fat necrosis secondary to poor blood supply in the injected fat5. Conservative treatment of breast cancer with lumpectomy & radiation therapy may also result in fat necrosis* Phenomena resulting from lymphatic obstruction in advanced breast cancer(i) Peaud's orange (due to cutaneous lymphatic oedema)(ii) Cancer-en-cuirasse(iii) Lymphangiosarcoma* Aromatase Inhibitors are used in Breast carcinoma are - Letrozole, Anastrozole, Exemestane, Aminoglutethimide