When is nipple discharge a concern

If the discharge is a nuisance, the ducts behind the nipple can be removed surgically. 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. 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 is an uncommon cause of nipple discharge.

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. 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. 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.

The discharge will usually stop when you stop expressing. Nipple discharge that is spontaneous, blood-stained, persistent, and unrelated to pregnancy or breast feeding needs to be investigated further.

Page last reviewed: 26 April Next review due: 26 April Nipple discharge. Nipple discharge is often normal Lots of women have nipple discharge from time to time. It may just be normal for you. Nipple discharge in men is not normal. The ductoscope is a newer technology that allows the observer to look directly into the breast ducts. The procedure can be done in the office and seems to be fairly well tolerated. Its role is yet to be defined. However, since most breast cancers start in the ducts, it is exciting to have new technology that allows us to visualize the duct.

Ductal lavage is a relatively new technique that evaluates a relatively large sample of cells that are washed out i. Mayo Clinic. American College of Obstetricians and Gynecologists. Practice Bulletin No. Paget disease of the breast. Dixon JM. Nonlactational mastitis.

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