International Journal of Breast Cancer breast cancer than incidentally identiﬁed ADH. Little data is available, but ADH associated with DCIS has been reported to increase the risk of contralateral breast cancer above that of DCIS alone, and clear surgical margins at duct excision for ADH did not aﬀect the risk of developing breast cancer [28]. A further 6 women, 4 of who had presented with spon- taneous bloodstained or serous discharge diagnosed with benign diagnoses following duct excision, have gone on to develop breast cancer, 3 in the contralateral breast. This would suggest that presenting with bloodstained or serous discharge may also be a marker of an increased risk of sub- sequently developing breast cancer. Dipstick testing of nipple discharge, for occult blood, to identify those who require duct excision has been described [29, 30]. Dipsticks are very sensitive, but are of low speciﬁcity. 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