“Blood-stained discharge from one breast can be sinister in nature and may represent an underlying carcinoma”

Emobileclinic Trending Topic: Nipple Discharge

Nipple discharge is the production of fluid from the nipple. The fluid comes from the milk gland ducts that open at the nipple. Although the average number of milk ducts opening on the surface of the nipple is 27, only five of these ducts are functional.

Most cases of nipple discharge are due to normal, benign conditions and are usually hormone-related. Approximately one third of all women can produce a nipple discharge by gently massaging their breasts. This ‘innocent’ nipple discharge usually comes from multiple ducts in both breasts in pre- menopausal women. Blood-stained discharge from a single duct in one breast can be sinister in nature and may represent an underlying carcinoma.

What to do if there is nipple discharge?

Women with nipple discharge should consult their GP without delay. They may then be referred to a breast specialist who will examine the breasts in more detail.

Diagnosis

Tests that may be done include:

Prolactin blood test

Thyroid blood tests

Head CT scan or MRI to look for pituitary tumor

Mammography

Ultrasound of the breast

Breast biopsy

Ductography or ductogram, an x-ray with contrast dye injected into the affected milk duct

Skin biopsy 

Causes of nipple discharge

Pain and nipple inversion or injury to the breast

Pregnancy

Recent breastfeeding

Rubbing on the area from a bra or t-shirt

Infection

Inflammation and clogging of the breast ducts

Noncancerous pituitary tumors

Small growth in the breast that is usually not cancer

Severe underactive thyroid gland (hypothyroidism)

Fibrocystic breast (normal lumpiness in the breast)

Use of certain medicines

Use of certain herbs, such as anise and fennel

Widening of the milk ducts

Sometimes, babies can have nipple discharge. This is caused by hormones from the mother before birth. It should go away in 2 weeks.

Symptoms

Nipple discharge that is NOT normal is:

Bloody

Comes from only 1 nipple

Comes out on its own without you squeezing or touching your nipple

Nipple discharge is more likely to be normal if it:

Comes out of both nipples

Happens when you squeeze your nipples

The color of the discharge does not tell you whether it is normal. The discharge can look milky, clear, yellow, green, or brown.

Squeezing your nipple to check for discharge can make it worse. Leaving the nipple alone may make the discharge stop.

Treatment

Once the cause of your nipple discharge is found, your doctor or nurse can recommend ways to treat it. You may:

Need to change any medicine that caused the discharge

Removal of lumps

Removal of all or some of the breast ducts

Receive creams to treat skin changes around your nipple

If all of your tests are normal, you may not need treatment. You should have another mammogram and physical exam within 1 year.

Possible Complications

Nipple discharge may be a symptom of breast cancer or a pituitary tumor. Skin changes around the nipple may be caused by Paget’s disease.