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    Nipple Discharge Fact Sheet

    This guide contains information about nipple discharge. Nipple discharge is the release of fluid from the nipple.

    Nipple Discharge

    [This information guide is also available in PDF format to download.]

    What is nipple discharge?

    Nipple discharge is the release of fluid from the nipple. It is a very common breast symptom and in most cases is part of the normal function of the breast rather than being caused by a problem. Nipple discharge alone (without a lump or other nipple change) is a very uncommon symptom of breast cancer. There are normally 15–20 milk ducts opening onto each nipple. Discharge can come from one or a number of these ducts.

    What are the features of nipple discharge?

    Nipple discharge may be:

    Spontaneous (fluid leaks from the breast without any squeezing of the nipple or pressure on the breast); or

    On expression (fluid only comes out of the nipple when the nipple is squeezed or there is pressure on the breast).

    Other questions which can be used to describe nipple discharge include:

    Is it coming from one breast (unilateral) or coming from both breasts (bilateral)?

    Is it coming from one duct (one opening on the nipple) or more than one?

    What colour is it? Nipple fluid is most often yellow, green or milky. This is not usually a cause for concern. Discharge that is blood-stained (bright red), brown or crystal clear can be more significant. If it is difficult to tell what colour it is, then putting some fluid onto a white tissue can help.

    Normal hormonal nipple discharge

    Nipple discharge is very common. Fluid can be obtained from the nipples of approximately 50–70% of normal women when special techniques, massage, or devices such as breast pumps are used. This discharge of fluid from a normal breast is referred to as ‘physiological discharge’.

    This discharge is usually yellow, milky, or green in appearance, it does not happen spontaneously, and it can often be seen to be coming from more than one duct. Physiological nipple discharge is no cause for concern.

    Milky nipple discharge (either spontaneous or on expression) is also normal (physiological) during pregnancy and breast feeding.

    When is nipple discharge abnormal?

    Spontaneous nipple discharge unrelated to pregnancy or breast feeding is considered abnormal. In most cases it has a non-cancerous (benign) cause. Spontaneous nipple discharge that is caused by disease (pathology) in the breast is more likely to be from one breast only (unilateral), confined to a single duct, and clear or blood-stained in appearance.

    Nipple discharge that is associated with other symptoms such as a lump in the breast or ulceration or inversion of the nipple needs prompt investigation, even if it is not spontaneous or blood-stained.

    What causes abnormal nipple discharge?

    There are many causes of nipple discharge. These include:

    Duct ectasia

    This is a non-cancerous (benign) condition in which the milk ducts under the nipple enlarge and there is inflammation in the walls of the ducts. It usually occurs in women after menopause. The discharge caused by duct ectasia usually comes from both breasts (bilateral), is yellow, green or brown, and comes from more than one duct. In most cases, no treatment is needed. If the discharge is a nuisance, the ducts behind the nipple can be removed surgically.

    Duct papilloma

    A duct papilloma is a growth within a milk duct in the breast, usually near the nipple. It may cause no symptoms, or it may cause a nipple discharge that is clear or blood-stained. It usually comes from a single duct and is from one breast only (unilateral). Rarely, duct papillomas can be associated with breast cancer and they can be difficult to diagnose confidently on a needle biopsy so they are usually removed surgically.

    Nipple eczema

    Eczema or dermatitis which affects the skin of the nipple, particularly if it becomes infected, can cause a weeping, crusty nipple discharge. The treatment is the same as for eczema elsewhere on the body; with cortisone-based creams the main first-line treatment.

    Breast cancer

    Breast cancer is an uncommon cause of nipple discharge. Less than 5% of women with breast cancer have nipple discharge, and most of these women have other symptoms, such as a lump or newly inverted nipple, as well as the nipple discharge.

    Paget’s disease of the nipple

    Paget’s disease is a particular type of breast cancer which involves the nipple. Paget’s disease typically causes ulceration and erosion of the nipple skin, and it may be associated with a blood-stained nipple discharge.

    Hormonal causes

    Galactorrhoea is milky nipple discharge not related to pregnancy or breast feeding. It is caused by the abnormal production of a hormone called prolactin. This can be caused by diseases of glands elsewhere in the body which control hormone secretion, such as the pituitary and thyroid glands.

    Drugs and medication

    Abnormally high prolactin levels can also be caused by some drugs. These include oral contraceptives, hormone replacement therapy, and medications used for the treatment of nausea, depression and psychiatric disorders. Drugs such as cocaine and stimulants can also cause high prolactin levels. It is also common after breast feeding to have a prolonged milky nipple discharge.

    How is nipple discharge treated?

    Nipple discharge diagnosed as ‘physiological discharge’ requires no treatment. It is important to stop expressing, or squeezing the nipple and breast, as this causes more fluid to be made. As in breast feeding, the breast will produce fluid to replace the fluid that is removed, and this will continue as long as you are expressing.

    Source : www.bci.org.au

    Nipple Discharge: Color, Causes, and Next Steps

    Nipple discharge may not be a sign of a serious health condition. Find out what symptoms should signal a trip to the doctor.

    Nipple discharge is any fluid or other liquid that comes out of your nipple. You might have to squeeze the nipple to get the fluid to come out, or it could seep out on its own.

    Nipple discharge is common during reproductive years, even if you’re not pregnant or breastfeeding. Discharge is usually not serious. Still, it can be a sign of breast cancer, so it’s worth talking about with a doctor.

    Keep reading to learn more about the different types of nipple discharge and when you should talk with your doctor.

    DID YOU KNOW?

    Your breasts each contain about 20 milk ducts, and fluid can leak from them. It’s normal for some milk to leak out of your nipple when you’re pregnant or lactating.

    Types and symptoms

    Nipple discharge comes in many colors. The color may give you some clues about the cause. The chart below lists the discharge colors and some possible causes if you’re not lactating.

    Color Possible cause

    white, cloudy, yellow, or filled with pus an infection of the breast or nipple

    green cysts

    brown or cheese-like mammary duct ectasia (blocked milk duct)

    clear breast cancer, especially if only coming from one breast

    papilloma bloody papilloma breast cancer

    The causes listed are only suggestions. You should see a doctor for a proper diagnosis if you notice nipple discharge of any color.

    Discharge can also come in a few textures. For example, it may be thick, thin, or sticky.

    The discharge might come out of just one nipple or both nipples. And it can leak out on its own or only when you squeeze the nipple.

    Some other symptoms you might have with nipple discharge include:

    breast pain or tenderness

    lump or swelling in the breast or around the nipple

    nipple changes, like turning inward, dimpling, changing color, itching, or scaling

    skin changes, such as rash or lesions

    redness

    breast size changes, such as one breast that’s larger or smaller than the other

    fever missed periods nausea or vomiting fatigue Causes

    When you’re pregnant or lactating, small amounts of milk might leak out. The leakage can start early in pregnancy, and you could continue to see milk for up to 2 or 3 years after ending nursing.

    However, you may have discharge even if you’re not pregnant or lactating. Other causes of nipple discharge include:

    birth control pills

    breast infection or abscess

    duct papilloma, a harmless wart-like growth in your milk duct

    drugs that increase levels of the milk-producing hormone prolactin, such as antidepressants and tranquilizers

    excess stimulation of the breast or nipple

    fibrocystic breasts

    hormone changes during your period or menopause

    injury to the breast

    mammary duct ectasia, known as a blocked milk duct

    prolactinoma, a noncancerous tumor of the pituitary gland

    underactive thyroid gland

    breast cancer

    Nipple discharge and breast cancer

    Breast cancer can cause nipple discharge, especially ductal carcinoma in situ (DCIS), an early form of breast cancer that starts in the milk ducts. It can also happen with Paget’s disease of the breast, a rare type of breast cancer that involves the nipple.

    If you do have breast cancer, the discharge will probably only come from one breast. You may have a lump in your breast, too.

    Discharge is rarely due to cancer, however. In an older study, only 9 percent

    Trusted Source Trusted Source

    of women 50 years or older who saw a doctor for nipple discharge had breast cancer.

    It’s still a good idea to get any breast discharge checked out, especially if it’s a new symptom for you.

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    LEARN MORE When to seek help

    Nipple discharge is usually nothing to worry about. Still, because it can be a sign of breast cancer, it’s worth having a doctor check it out. It’s especially important to see a doctor if:

    you have a lump in your breast

    you have nipple or skin changes, such as crusting or color change

    you have pain in your breast or other symptoms of breast cancer

    the discharge is bloody

    only one breast is affected

    the discharge doesn’t stop

    In men, it’s important to see a doctor if you notice any nipple discharge as it’s uncommon.

    Your doctor will start by asking questions about the discharge, including:

    When did the discharge start?

    Is it in one breast or both?

    Does it come out on its own, or do you have to squeeze the nipple to produce it?

    What other symptoms do you have?

    What medications do you take?

    Are you pregnant or breastfeeding?

    The doctor will do a clinical exam to check your breasts for lumps or other signs of cancer. You may also have one or more of these tests:

    Biopsy. The doctor removes a small sample of tissue from your breast to check it for cancer.Mammogram. This test takes X-ray pictures of your breasts to help the doctor look for cancer.

    Source : www.healthline.com

    Breast and Nipple Discharge: What It Could Mean

    WebMD explains breast and nipple discharge and what it might indicate. Know what to look for and learn about the possible reasons for discharge.

    Breast and Nipple Discharge: What It Could Mean

    By Hilary Parker

    Medically Reviewed by Traci C. Johnson, MD on November 06, 2020

    For women who aren't breastfeeding, the sight of nipple discharge can be alarming. But if you notice discharge from your nipple, there's no reason to panic. While nipple discharge can be serious, in most cases, it's either normal or due to a minor condition.

    Still, if you are not nursing, you should contact your health care provider any time you notice breast discharge. Based upon your symptoms and the results of diagnostic tests, your doctor will decide on the best course of treatment.

    What is normal and what is abnormal nipple discharge?

    Bloody nipple discharge is never normal. Other signs of abnormality include nipple discharge from only one breast and discharge that occurs spontaneously without anything touching, stimulating, or irritating your breast.

    Color isn't usually helpful in deciding if the discharge is normal or abnormal. Both abnormal and normal nipple discharge can be clear, yellow, white, or green in color.

    Normal nipple discharge more commonly occurs in both nipples and is often released when the nipples are compressed or squeezed. Some women who are concerned about breast secretions may actually cause it to worsen. They do this by repeatedly squeezing their nipples to check for nipple discharge. In these instances, leaving the nipples alone for a while may help the condition to improve.

    Based on your medical evaluation, your doctor will determine whether your nipple discharge is normal (physiologic) or abnormal (pathologic). Even if your doctor determines your breast discharge is abnormal, keep in mind that most pathological conditions that cause nipple discharge are not serious and are easily treated.

    What might cause normal nipple discharge?

    Some causes of normal nipple discharge include:

    Pregnancy. In the early stages of pregnancy, some women notice clear breast discharge coming from their nipples. In the later stages of pregnancy, this discharge may take on a watery, milky appearance.

    Stopping breastfeeding. Even after you have stopped nursing your baby, you may notice that a milk-like breast discharge persists for a while.Stimulation. Nipples may secrete fluid when they are stimulated or squeezed. Normal nipple discharge may also occur when your nipples are repeatedly chafed by your bra or during vigorous physical exercise, such as jogging.

    What causes abnormal nipple discharge and can it be noncancerous?

    A number of noncancerous conditions can cause nipple discharge.

    If your initial medical evaluation indicates the discharge is abnormal, your doctor may ask for more tests. The tests will help determine the underlying condition that's causing the problem and may include one or more of the following:

    Laboratory analysis of the discharge

    Blood tests

    Mammogram and/or ultrasound of one or both breasts

    A brain scan

    Surgical excision and analysis of one or more ducts in your nipple

    Possible causes of abnormal discharge include:

    Fibrocystic breast changes. Fibrocystic refers to the presence or development of fibrous tissue and cysts. Fibrocystic changes in your breasts may cause lumps or thickenings in your breast tissue. They do not indicate, though, the presence of cancer. In addition to causing pain and itching, fibrocystic breast changes can, at times, cause secretion of clear, white, yellow, or green nipple discharge.Galactorrhea. It might sound scary. But galactorrhea simply describes a condition in which a woman's breast secretes milk or a milky nipple discharge even though they are not breastfeeding. Galactorrhea is not a disease and has many possible causes. These include:

    Pituitary gland tumors

    Certain medications, including some hormones and psychotropic drugs

    Some herbs, such as anise and fennel

    Hypothyroidism

    Illegal drugs, including marijuana

    Infection. Nipple discharge that contains pus may indicate an infection in your breast. This is also known as mastitis. Mastitis is usually seen in women who are breastfeeding. But it can develop in women who are not lactating. If you have an infection or abscess in your breast, you may also notice that your breast is sore, red, or warm to the touch.Mammary duct ectasia. This is the second most common cause of abnormal nipple discharge. It is typically seen in women who are approaching menopause. This condition results in inflammation and possible blockage of ducts located underneath the nipple. When this occurs, an infection may develop that results in thick, greenish nipple discharge.Intraductal papilloma. These are noncancerous growths in the ducts of the breast. They are the most common reason women experience abnormal nipple discharge. When they become inflamed, intraductal papillomas may result in nipple discharge that contains blood or is sticky in texture.

    What is the connection between nipple discharge and breast cancer?

    Most nipple discharge is either normal or caused by a benign medical condition. There are instances, though, when discharge from the breast may be a symptom of some forms of breast cancer. This likelihood is greater if your nipple discharge is accompanied by a lump or mass within the breast or if you have had an abnormal mammogram.

    One form of breast cancer that may cause breast discharge is intraductal carcinoma. This cancer develops within the ducts of the breast located beneath the nipple.

    Source : www.webmd.com

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