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Private microdochectomy in London, by a consultant breast surgeon.

Definitive treatment for single-duct pathological nipple discharge - with a full triple assessment first, tissue diagnosis afterwards, and honest alternatives on the table before you agree to surgery.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private microdochectomy costs in London.

Indicative ranges across UK private providers.

In short

£2,500–£3,800, home the same day.

Procedure Indicative range
Microdochectomy under LA and sedation £2,500–£3,800
Microdochectomy under GA £3,200–£4,500
Central duct excision (Hadfield’s) £3,500–£5,200
Ductoscopy (specialist centres) £1,800–£2,800
MR ductography £800–£1,400
Consultation and triple assessment £400–£900

Prices vary by clinic, by which surgeon does the case, by the anaesthetic chosen and by whether ductoscopy or MR ductography is added to the work-up.

The problem

The right work-up, the right operation, the right surgeon.

Nipple discharge is one of the most under-triaged symptoms in the private market - either dismissed or over-operated. We fix the work-up before anyone reaches for a scalpel.

  • Not sure it is pathological?

    Discharge from many ducts on both sides is usually benign. We separate the ones that need surgery from the ones that need reassurance.

  • Worried it could be cancer?

    About 5 to 10 per cent of pathological single-duct discharge turns out to be DCIS. Excision gives you a proper diagnosis, not a guess.

  • Want it done properly?

    A named consultant breast surgeon, a proper day-case theatre, and histology from a specialist breast pathologist within 7 to 14 days.

When it helps

When microdochectomy is the right step.

The clinical pictures that point to a single duct - plus the red flags that mean an urgent breast pathway, not a routine appointment.

  • Single-duct bloody discharge

    Spontaneous, unilateral, from a single duct orifice - the classic indication for microdochectomy.

  • Single-duct serous discharge

    Clear or straw-coloured, single duct, persistent - still counts as pathological and warrants work-up.

  • Suspected intraductal papilloma

    The commonest cause of pathological single-duct discharge - excision gives symptom relief and a diagnosis.

  • Duct ectasia with focal discharge

    When ectasia points to one duct rather than many, targeted excision may still be the right answer.

  • Discharge after normal imaging

    Mammography and ultrasound can be normal even with real intraductal pathology - a single-duct symptom is enough.

  • To rule out DCIS or malignancy

    Around 5 to 10 per cent of pathological discharge is DCIS, and a small minority invasive - tissue diagnosis matters.

  • Failed watchful waiting

    If discharge has been observed but has not settled or is bothering you, definitive excision is the next step.

  • Red flag: lump, skin change or bloody discharge

    A new breast lump, skin dimpling, nipple retraction or persistent bloody discharge is a 2WW referral, not a wait-and-see.

Procedure options

Microdochectomy is not the only option.

What each option on the table actually involves - and which fits which pattern of discharge.

  • Microdochectomy (single duct)

    The affected duct is identified with a lacrimal probe or methylene blue, then excised with a small tissue cuff and sent for histology.

  • Central duct excision (Hadfield’s)

    A broader excision of the major subareolar ducts for multi-duct discharge or when the offending duct cannot be isolated.

  • Ductoscopy with targeted biopsy

    A tiny endoscope enters the duct through the nipple orifice in specialist centres, allowing direct visualisation and focused biopsy.

  • MR ductography

    Contrast breast MRI increasingly replaces conventional galactography for mapping the offending duct and excluding other lesions.

  • Watchful waiting

    Reasonable when imaging is normal, cytology is negative and the discharge is not bloody - with a clear plan for re-review.

  • Steroid or antibiotic trial

    Occasionally used for a suspected inflammatory or infective picture before deciding on surgery.

  • Excision biopsy of a palpable lesion

    If imaging or clinical exam finds a discrete mass, that is excised in its own right rather than as a ductal procedure.

  • Consultation only

Safety and recovery

What to expect afterwards - honestly.

Microdochectomy is a common, safe day-case procedure. The things worth planning are anaesthetic choice, dressing care and knowing what is normal in the days after.

  • Local plus sedation or a light GA

    Most microdochectomies are done under LA with IV sedation. A short GA is a reasonable choice if you would rather not be aware.

  • Bleeding and bruising are usually minor

    A little oozing and bruising around the areola for a few days is normal. Significant bleeding or haematoma is uncommon and manageable.

  • Infection is uncommon

    Wound infection is the main non-bleeding risk. Spreading redness, fever or increasing pain warrants a same-day call.

  • Nipple sensation may change

    Numbness or altered sensation around the nipple is common in the first weeks and usually recovers over months.

  • Scar visibility settles over months

    A periareolar or radial scar looks pink at first, then fades - usually well-camouflaged, especially at the areolar edge.

  • Breastfeeding from the affected breast

    A single-duct excision usually leaves plenty of functioning ducts; central duct excision typically prevents breastfeeding from that side.

  • Rare inversion of the nipple

    More common after central duct excision than microdochectomy - discussed honestly beforehand.

  • Recurrence from an adjacent duct

    A small proportion of patients develop discharge from a different duct later and may need further surgery.

  • Red flags after surgery

    Fever, spreading redness, heavy bleeding or a new lump after the procedure are not normal - call the clinic or A&E the same day.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever technique was used, the note the breast surgeon sends you keeps to the same shape.

A UK consultant breast surgeon reviewing a patient’s operation notes

A quiet reminder

Surgical and histology language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the operation note or the pathology report before your review, just ask.

  1. 01 Header

    Indication and side

    Which breast, which duct orifice, the character of the discharge and the imaging that led to surgery.

  2. 02 Technique

    Anaesthetic and surgical approach

    Whether it was done under LA with sedation or GA, the incision used (periareolar or radial), and how the duct was identified.

  3. 03 Findings

    Duct, cuff of tissue and specimen

    What was excised, whether a probe or dye was used, and confirmation that the specimen was sent for histology.

  4. 04 Impression

    Recovery, results timing and follow-up

    Read this first: expected recovery, when histology is due, and whether a further step is anticipated depending on the result.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for microdochectomy is usually approved when there is a clinical indication and appropriate imaging.

Frequently asked

Everything we get asked about microdochectomy.

Quick answers on when discharge is pathological, what the surgery actually removes, recovery and what the histology means.

  • What is a microdochectomy?

    A microdochectomy is the surgical excision of a single (or grouped) breast duct that is producing pathological nipple discharge. The duct is identified, removed with a small cuff of surrounding tissue, and sent for histology to make a diagnosis.

  • When is nipple discharge actually pathological?

    When it is spontaneous (not squeezed out), unilateral, from a single duct orifice, persistent and either bloody or serous. Discharge from many ducts on both sides - especially when squeezed - is usually benign and does not need surgery.

  • What causes single-duct nipple discharge?

    Most often an intraductal papilloma - a benign polyp inside the duct. Duct ectasia, DCIS (around 5 to 10 per cent of pathological cases) and, rarely, invasive breast cancer can also present this way. Microdochectomy both treats the symptom and gives a diagnosis.

  • What does the assessment involve before surgery?

    Triple assessment: a clinical breast exam by a consultant breast surgeon, imaging (mammography if over 35 plus ultrasound), cytology of the discharge, and often MR ductography or ductoscopy to map the offending duct.

  • How much does a private microdochectomy cost in London?

    Roughly £2,500 to £3,800 under LA with sedation, and £3,200 to £4,500 under GA. A central duct excision (Hadfield’s) is £3,500 to £5,200. NHS funding through the two-week-wait breast pathway is also usually available.

  • How long is the recovery?

    Most people are back at a desk job within 3 to 7 days. No heavy lifting for 2 weeks, no bra for 3 to 5 days and then a supportive bra, histology results at 7 to 14 days and a review at 4 to 6 weeks.

  • Will I still be able to breastfeed?

    Almost always, yes, if only one duct has been removed - the other 15 to 20 ducts on that side are untouched. A central duct excision usually prevents breastfeeding from that breast, and this is discussed openly beforehand.

  • What happens if the histology shows atypia or DCIS?

    Benign papilloma needs no further surgery. Atypical hyperplasia usually means closer surveillance. DCIS or invasive cancer is planned with a breast MDT - often further wide local excision, sentinel node biopsy or oncological treatment as needed.

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