Noticing abnormal nipple discharge can be worrying, especially when the discharge is spontaneous, persistent, or blood-stained. While many cases are linked to benign breast conditions, it is important to undergo a proper medical assessment to determine the underlying cause.
In Singapore, a microdochectomy is a commonly performed breast surgery used to diagnose and treat nipple discharge arising from a single milk duct. The procedure is often recommended when imaging or clinical findings suggest an intraductal papilloma or another abnormality affecting one duct.
In this article we explain what a microdochectomy is, when it may be recommended, the procedure itself, estimated costs in Singapore, and what patients can expect during recovery.
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What Is a Microdochectomy?
A microdochectomy is a surgical procedure involving the removal of a single milk duct from the breast. It is most commonly performed for patients experiencing pathological nipple discharge, particularly when the discharge:
- Occurs spontaneously without squeezing
- Comes from a single duct
- Affects only one breast
- Appears bloody, clear, or serous
- Persists over time
The procedure serves both a diagnostic and therapeutic purpose. The affected duct is removed to stop the discharge, and the tissue is sent for laboratory analysis to rule out underlying abnormalities, including breast cancer.
Compared to a total duct excision, which removes multiple ducts beneath the nipple, a microdochectomy is considered more conservative because only the affected duct is removed. This may help preserve the ability to breastfeed in the future.
Conditions That May Require a Microdochectomy
A breast specialist in Singapore may recommend a microdochectomy for conditions such as:
- Intraductal papilloma
- Persistent single-duct nipple discharge
- Bloody nipple discharge
- Suspicious ductal abnormalities detected on imaging
- Recurrent nipple discharge despite conservative management
Not all nipple discharge requires surgery. Milky discharge from both breasts, especially in women who are breastfeeding or taking certain medications, may have hormonal causes instead.
Microdochectomy Cost in Singapore
The cost of a microdochectomy in Singapore can vary depending on factors such as:
- Whether the procedure is performed in a public or private hospital
- Whether one or both breasts require surgery
- Complexity of the condition
- Length of stay
- Additional imaging, pathology, and laboratory investigations required
According to the Ministry of Health (MOH) fee benchmarks, the following are the recommended professional fee ranges for routine and typical cases in private hospitals and clinics.
MOH Fee Benchmarks for Microdochectomy in Singapore
| Procedure | Surgeon Fee | Anaesthetist Fee | Inpatient Doctor Attendance Fees |
|---|---|---|---|
| Microdochectomy (Unilateral) – TOSP SA702B | S$2,800 – S$3,900 (before GST) | S$850 – S$1,200 (before GST) | S$210 – S$420 per day (before GST) |
| Microdochectomy (Bilateral) – TOSP SA701B | S$3,400 – S$4,700 (before GST) | S$1,200 – S$1,800 (before GST) | S$210 – S$420 per day (before GST) |
Important note: The fees above refer only to professional fees recommended by MOH for private hospitals and clinics. They do not include hospital charges, operating theatre fees, medications, consumables, imaging investigations, histology or laboratory testing, or Goods and Services Tax (GST). Actual bill sizes may vary depending on the patient’s condition, complexity of surgery, hospital, and duration of stay.
Patients are encouraged to consult their healthcare provider and insurer for a personalised cost estimate and to understand MediSave and Integrated Shield Plan coverage eligibility.
How Is a Microdochectomy Performed?
In Singapore, a microdochectomy is usually performed as a day surgery procedure under general anaesthesia.
Before the Procedure
Your breast surgeon may arrange imaging tests to identify the affected duct and assess the surrounding breast tissue. These investigations may include:
- Breast ultrasound
- Mammogram
- Magnetic resonance imaging (MRI) in selected cases
- Cytology or laboratory testing of the nipple discharge
The surgeon may also identify the exact duct opening before surgery to ensure accurate removal of the affected duct.
During the Procedure
A small incision is made along the edge of the areola, which is the darker skin surrounding the nipple. This approach helps minimise visible scarring.
The surgeon then identifies and removes the abnormal duct along with any associated lesion or tissue abnormality. The tissue sample is subsequently sent for histological examination.
The surgery generally takes less than one hour.
After the Procedure
Most patients can return home on the same day after recovery from anaesthesia.
Dissolvable stitches are commonly used, and the wound is covered with a dressing. Patients are usually given post-operative instructions regarding wound care, physical activity, and follow-up appointments.
Recovery After Microdochectomy
Recovery after a microdochectomy is generally straightforward. Many patients are able to resume desk-based work within several days, depending on their comfort level and the nature of their job.
Common post-operative experiences may include:
- Mild swelling
- Bruising around the incision
- Temporary soreness or discomfort
Your surgeon may advise you to:
- Avoid strenuous upper-body activity for approximately one to two weeks
- Keep the wound clean and dry
- Wear a supportive bra during recovery
- Attend follow-up appointments for wound review and biopsy results
Risks and Possible Complications
As with any surgical procedure, a microdochectomy carries certain risks, although serious complications are uncommon.
Possible risks include:
- Bleeding
- Infection
- Bruising or haematoma
- Scarring
- Temporary nipple sensitivity changes
- Recurrence of nipple discharge
- Difficulty breastfeeding from the affected duct
Your breast surgeon will discuss the benefits and risks of the procedure based on your individual condition.
Specialist You May Consider
Choosing an experienced breast specialist is important when managing persistent or abnormal nipple discharge. A breast surgeon can evaluate the cause of the discharge, recommend appropriate investigations, and advise whether a microdochectomy or other treatment may be suitable for your condition.
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Frequently Asked Questions (FAQs)
1. Is a microdochectomy painful?
The procedure itself is performed under general anaesthesia, so patients do not feel pain during surgery. Mild soreness or discomfort after the procedure is common and is usually manageable with prescribed medication.
2. Will there be visible scarring after a microdochectomy?
The incision is typically made along the edge of the areola to reduce visible scarring. In many cases, the scar becomes less noticeable over time.
3. Can I still breastfeed after a microdochectomy?
Many women are still able to breastfeed after the procedure because only one milk duct is removed. However, this may vary depending on the individual and the extent of surgery performed.
4. Is nipple discharge always a sign of breast cancer?
No. Many cases of nipple discharge are caused by benign conditions such as intraductal papillomas or duct ectasia. However, persistent, bloody, or single-duct discharge should be medically assessed to rule out more serious conditions.
5. How long does it take to receive biopsy results after surgery?
In Singapore, biopsy or histology results are commonly available within several working days, although turnaround time may differ between laboratories and healthcare institutions.