Which investigations should be considered for a patient presenting with unilateral nipple discharge?

Investigations for unilateral nipple discharge should include:

• Clinical breast examination to assess for any palpable lumps or abnormalities.
• Breast imaging: Ultrasound and mammography are recommended to evaluate the underlying breast tissue and identify any suspicious lesions.
• Referral for specialist assessment: If imaging or clinical findings are suspicious, refer the patient using a suspected cancer pathway referral.
• Ultrasound-guided needle sampling may be performed if abnormal lymph nodes or lesions are identified on imaging.

These steps align with NICE guidance on the diagnosis and management of breast symptoms suspicious for cancer, including nipple discharge, emphasizing prompt imaging and referral to exclude malignancy ²,¹.