With papillary carcinoma, which discharge is most characteristic?

• A. Milky discharge
• B. Bloody discharge from a single duct
• C. Clear watery discharge
• D. No discharge

Answer: (B)

Bloody discharge from a single duct is most characteristic because papillary carcinoma grows as a papillary projection inside a duct, which disrupts fragile ductal vessels and bleeds into the lumen. This produces unilateral, serosanguinous or bloody discharge from the involved duct, often without affecting other ducts. In contrast, milky discharge points to galactorrhea or hormonal causes, clear watery discharge is more typical of benign ductal conditions, and no discharge doesn’t define this lesion. The key point is that an intraductal papillary lesion tends to cause blood-tinged discharge from one duct, making that presentation highly suggestive of papillary pathology.