Collection Manual: Breast nipple discharge


Description: Breast nipple discharges are submitted for the evaluation of cellular pathology.

MATERIALS
Microscope slides, spray-fix (CAUTION: POISON, FLAMMABLE), slide mailer, requisition form, biohazard transport bag.

PROCEDURE
1. Complete a requisition form
White copy to the lab. Lack of data may result in delay or specimen rejection.
Include:
• Clinician name, location and date of service.
• Patient demographics: Name, address, phone number, date of birth and social security number.
• Insurance information: copy of insurance card(s) or face sheet.
• Description
a) Site description including laterality, tenderness, onset of discharge, other symptoms.
b) Discharge description including bloody, clear, color, consistency, volume (ml).
• Patient history: previous breast pathology, family history, mammography results and suspected diagnosis.
• Related treatments: including radiation, chemotherapy and surgery.

2. Label the slide(s) with the patient’s first and last name.
• Use pencil (ink will dissolve in processing). It is not necessary to label the slide holder.
• Unlabeled samples will be returned.

3. Milk the subareolar area and nipple.
• Gently use the thumb and forefinger to discharge material from the nipple.

4. Collect the specimen onto the slide.
• Draw a slide across the nipple to collect the discharge.
• If the sample is thick, spread it out thinly using a second slide.

5. Immediately spray fix the specimen.
• Hold the spray-fix bottle 8 inches from slide and fix with 3 pumps of fixative.
• Place the fixed slide(s) in the slide mailer and allow them to dry, then close the slide folder.

6. Repeat the process until there is no additional discharge.
• 2 to 4 slides are suggested.

7. Submit in a biohazard transport bag.
• Place the slides in the zip-loc portion of the transport bag and the requisition form in the outer sleeve.

8. Refrigeration is not required.