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Nipple discharge

Discharge from breasts; Milk secretions; Lactation - abnormal; Witch's milk (neonatal milk); Galactorrhea; Inverted nipple; Nipple problems

 

Nipple discharge is any fluid that comes out of the nipple area in your breast.

Causes

 

Sometimes discharge from your nipples is OK and will get better on its own. You are more likely to have nipple discharge if you have been pregnant at least once.

Nipple discharge is most often not cancer (benign), but rarely, it can be a sign of breast cancer. It is important to find out what is causing it and to get treatment. Here are some reasons for nipple discharge:

  • Pregnancy
  • Recent breastfeeding
  • Rubbing on the area from a bra or t-shirt
  • Injury to the breast
  • 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.

Cancers such as Paget disease (a rare type of cancer involving the skin of the nipple) can also cause nipple discharge.

 

Symptoms

 

Nipple discharge that is NOT normal is:

  • Bloody
  • Comes from only one 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.

 

Exams and Tests

 

Your health care provider will examine you and ask questions about your symptoms and medical history.

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 , if Paget disease is a concern

 

Treatment

 

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

  • Need to change any medicine that caused the discharge
  • Have lumps removed
  • Have all or some of the breast ducts removed
  • Receive creams to treat skin changes around your nipple
  • Receive medicines to treat a health condition

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

 

Outlook (Prognosis)

 

Most of the time, nipple problems are not breast cancer . These problems will either go away with the right treatment, or they can be watched closely over time.

 

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 disease.

 

When to Contact a Medical Professional

 

Have your provider evaluate any nipple discharge.

 

 

References

Hunt KK, Mittendorf EA. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 20th ed. Philadelphia, PA: Elsevier; 2017:chap 34.

Kaiser U, Ho KKY. Pituitary physiology and diagnostic evaluation. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 8.

Sandadi S, Rock DT, Orr JW, Valela FA. Breast diseases: detection, management, and surveillance of breast disease. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 15.

 
  • Female Breast - illustration

    The female breast is either of two mammary glands (organs of milk secretion) on the chest.

    Female Breast

    illustration

  • Intraductal papilloma - illustration

    Intraductal papilloma is a benign tumor inside a milk duct. Removal of the duct for biopsy may be recommended to rule out cancer.

    Intraductal papilloma

    illustration

  • Mammary gland - illustration

    The anatomy of the breast includes the lactiferous, or milk ducts, and the mammary lobules.

    Mammary gland

    illustration

  • Abnormal discharge from the nipple - illustration

    Abnormal nipple discharge may be described as any discharge not associated with lactation. The nature of the discharge may range in color, consistency and composition, and occur in one or both breasts.

    Abnormal discharge from the nipple

    illustration

  • Normal female breast anatomy - illustration

    The female breast is composed mainly of fatty tissue interspersed with fibrous or connective tissue. The circular region around the nipple is often a different color or pigmented. This region is called the areola.

    Normal female breast anatomy

    illustration

    • Female Breast - illustration

      The female breast is either of two mammary glands (organs of milk secretion) on the chest.

      Female Breast

      illustration

    • Intraductal papilloma - illustration

      Intraductal papilloma is a benign tumor inside a milk duct. Removal of the duct for biopsy may be recommended to rule out cancer.

      Intraductal papilloma

      illustration

    • Mammary gland - illustration

      The anatomy of the breast includes the lactiferous, or milk ducts, and the mammary lobules.

      Mammary gland

      illustration

    • Abnormal discharge from the nipple - illustration

      Abnormal nipple discharge may be described as any discharge not associated with lactation. The nature of the discharge may range in color, consistency and composition, and occur in one or both breasts.

      Abnormal discharge from the nipple

      illustration

    • Normal female breast anatomy - illustration

      The female breast is composed mainly of fatty tissue interspersed with fibrous or connective tissue. The circular region around the nipple is often a different color or pigmented. This region is called the areola.

      Normal female breast anatomy

      illustration

    A Closer Look

     

      Self Care

       

      Tests for Nipple discharge

       

         

        Review Date: 10/4/2016

        Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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