NBME Form 7 Practice Test

Nipple discharge that is small in amount, can be expressed by squeezing, is yellow in color, and occurs without spontaneous leakage or a detectable mass with a negative imaging study is most consistent with benign physiologic discharge. In this scenario, there is no mass or infection signs, and the discharge can be elicited with manipulation rather than occurring on its own, which argues against a pathologic ductal lesion, abscess, or inflammatory process. Mammography being negative further supports a non-neoplastic, physiologic cause. Mammary duct ectasia, for example, often presents with thicker periareolar tissue and sometimes a palpable mass or tender thickened ducts and often produces a sticky or greenish discharge, which isn’t described here. Eczema would cause skin changes rather than a fluid discharge. So the presentation best fits physiologic nipple discharge.