<< Back to the abstract archive
Milk Production After Nipple-Sparing Mastectomy: A Case Report and Review of the Literature
M. Asher Schustemran II, MD; Carolyn De La Cruz, MD
UPMC
2020-01-26
Presenter: M. Asher Schusterman II
Affidavit:
This is original work of the resident.
Director Name: Vu T. Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
BACKGROUND: Breast milk production after nipple-sparing mastectomy (NSM) is rare occurrence and typically occurs only in post-partum patients. This study sought to determine the frequency of this finding in the literature as well as report a case of this at our institution.
METHODS: We reviewed our breast reconstruction cases for incidences of nipple discharge after NSM and performed a literature search for all studies reporting nipple discharge after NSM.
RESULTS: Our review yielded one case: a 31-year-old female who underwent bilateral prophylactic NSM for BRCA gene positivity and subsequent implant-based reconstruction. She began experiencing breast milk production from her left nipple one month after expander-to-implant exchange without associated pregnancy. Work-up included referral to endocrinology and evaluation for possible pituitary tumor. She had no other surgical complications. Literature review revealed only 2 papers on this subject: a case report published in 2011 of a patient who had watery nipple discharge after NSM and a retrospective chart review from 2017 citing a 22% rate of milky nipple discharge after NSM in the postpartum period, but no cases of milk production without associated pregnancy. This study also reported a 0.22% rate of watery nipple discharge after NSM without associated pregnancy.
CONCLUSION: To our knowledge, this is the first reported case of breast milk production after NSM that was not associated with pregnancy. Milk production is a rare but possible sequelae after NSM that can occur not only in post-partum patients. Therefore, it is important to understand the implications and work-up of this finding.
