Nipple Discharge

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Definition

What is nipple discharge?

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. A nipple discharge may look milky, or it may be clear, yellow, green, brown or bloody. Non-milk discharge comes out of your nipple through the same nipple openings that carry milk. The consistency of nipple discharge can vary — it may be thick and sticky or thin and watery. Discharge is usually not serious. Still, it can be a sign of breast cancer, so it’s worth seeing your doctor about.

How common is nipple discharge?

Nipple discharge is common during your reproductive years even if you’re not pregnant or breastfeeding. Nipple discharge in men under any circumstances could be a problem and needs further evaluation. Please discuss with your doctor for further information.

Which signs and symptoms can nipple discharge usually be associated with?

Related signs and symptoms include:

  • Breast pain or tenderness
  • Lump or swelling in the breast or around the nipple
  • Nipple changes, like turning inward, dimpling, color changes, itching, or scaling
  • Redness
  • Breast size changes, such as one breast that’s larger or smaller than the other
  • Fever
  • Missed periods
  • Nausea or vomiting
  • Fatigue

Causes

What causes nipple discharge?

Causes of nipple discharge can include:

  • Local irritationor inflammation. Irritation of the nipples from rough clothing or an improperly fitting bra, as well as excess stimulation or trauma to the breasts may cause discharge.
  • Fibrocystic changes. Premenopausal women who have fibrocystic breasts may have breast discharge before their periods. Symptoms may include breast pain, lumpy breasts, and a yellow-green or brown discharge.
  • Hormonal changes and medications. Normal hormonal changes, as well as medications such as birth control pills may cause nipple discharge.
  • Infections (mastitis or abscess). Mastitis, a breast infection may cause purulent (pus-like) yellow-green discharge along with a fever, pain, and breast tenderness.A breast abscess, especially a nipple or subareolar abscess is a localized infection in which the body has “walled off” the infection. The discharge is similar to that with mastitis, but is often foul-smelling as well.
  • Medications. Hormonal therapies such as birth control pills also sedatives, often cause a milky discharge
  • Galactorrheaor hyperprolactinemia. A milky discharge, similar to that seen in women who are breastfeeding, may occur in women who aren’t breastfeeding, men, or even young children, and is referred to as galactorrhea. It is most often due to an increased level of the hormone prolactin in the blood (a hormone secreted by the pituitary gland that is involved with breast development and breastfeeding), in a condition referred to as hyperprolactinemia. In women, hyperprolactinemia is often accompanied by amenorrhea (lack of menstrual periods), but in men, nipple discharge may be the first symptoms.
  • Mammary duct ectasia (dilated milk ducts). Mammary duct ectasia, or blocked milk ducts, is a condition most often found in women who are nearing menopause (perimenopause) or after menopause. It occurs when the breast ducts widen and become clogged with thick discharge. The discharge can be green, brown, or even black, and very thick and cheese-like. It is often accompanied by nipple tenderness and redness. It may lead to a secondary bacterial infection (mastitis) and can also cause the nipples to turn inwards (nipple inversion) raising concern about breast cancer. It usually goes away in time, with relief provided by hot packs, but sometimes requires surgical treatment.
  • Intraductal papillomas. Intraductal papillomas are usually benign growths that most often involve a single duct. They are most common in premenopausal women, and often cause a clear or bloody discharge. A lump may be felt on the nipple, but is often non-tender. Most are benign, but they may contain regions of papillary carcinoma of the breast, a type of ductal carcinoma in situ (DCIS). A ductogram or needle biopsy may be done, and if there is concern, the papilloma can be surgically removed.
  • Breast cancer and carcinoma in situ. While breast cancer is not a common cause of nipple discharge, it can be an early warning sign of breast cancer that is still in the preinvasive stage (ductal carcinoma in situ), especially when it occurs in a woman over the age of 40, is associated with a breast mass, is bloody, unilateral, or involves only one duct.Though nipple discharge related to breast cancer is often thought to be bloody, this is not necessarily the case, and the discharge may be clear or milky. This reinforces the fact that any nipple discharge that does not have an obvious cause (and even if it does at times) should be evaluated.
  • Paget’s disease of the breas Paget’s disease of the breast is an uncommon form of breast cancer, accounting for only 1 percent to 4 percent of cases. In addition to nipple discharge that is often bloody, it may cause nipple tenderness or burning, and redness, scaling, or flaking of the nipple. A biopsy is usually needed to make the diagnosis.

The conditions mentioned above are some common causes of nipple discharge. Consult with your doctor for an accurate diagnosis.

Risk factors

What increases my risk for nipple discharge?

You are more likely to experience nipple discharge if you have any of the conditions mentioned above.

Please consult with your doctor for further information.

When to see your doctor

When should I see my doctor?

You should contact your doctor if you or your loved one has any of the following:

  • Alump in the breast
  • Nipple changes (such as crusting or color change)
  • Pain in thebreast or other symptoms of breast cancer
  • Bloody discharge
  • Only one breast is affected
  • The discharge doesn’t stop

On noticing one of these symptoms or having any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor to get the best solutions for your situation.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage nipple discharge?

Lifestyle changes and home remedies hardly are effective in dealing with nipple discharge. It’s recommended to seek medical treatment.

If you have any questions, please consult with your doctor for the best solutions.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 15, 2019 | Last Modified: January 15, 2019

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