Nipple discharge
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Nipple discharge is fluid from the nipple, with or without squeezing the breast.[2][5] The discharge can be milky, clear, green, purulent, bloody, or faintly yellow.[6] The consistency can be thick, thin, sticky, or watery.[5][6]
Nipple discharge | |
---|---|
Milk coming from the nipple | |
Specialty | Gynecology |
Types | Physiologic, pathologic[1] |
Diagnostic method | Normal: Late pregnancy, after childbirth, newborns[2][3] Abnormal: Intraductal papilloma, duct ectasia, blocked milk duct, infected breast, breast cancer, high prolactin[1][4][3] |
Treatment | Depends on the cause[2] |
Frequency | Common[2] |
Nipple discharge may be normal, such as milk in late pregnancy or after childbirth, and in newborns during the first weeks of life.[2][3] It may also be normal following squeezing, in women during the reproductive years.[2][5] It is likely abnormal if it occurs in men, contains blood, is from only one breast, or is associated with a breast lump, swelling, redness or overlying skin changes.[2][3] Reasons for abnormal discharge include an intraductal papilloma, duct ectasia, blocked milk duct, infected breast (mastitis or breast abscess), breast cancer, certain medications, and conditions that raise prolactin.[1][3][4]
Milky discharge in a non-pregnant, non-breast feeding women is evaluated differently to other abnormal nipple discharge.[4] Often, the cause can be determined based on symptoms and examination.[5] Blood tests may be done to rule out low thyroid or high prolactin.[7] Other tests may include mammography, breast ultrasound, breast biopsy, or skin biopsy.[8]
Treatment depends on the underlying cause.[2] Duct ectasia may be treated with surgical removal of the ducts involved.[2] Infectious causes may require antibiotics or incision and drainage.[2] Nipple discharge is the third most common breast complaint by women, after breast pain and a breast lump.[4] About 3% of breast cancer cases are associated with discharge.[4][9]