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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:
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Prolactin blood test
Prolactin blood test
Prolactin is a hormone released by the pituitary gland. The prolactin test measures the amount of prolactin in the blood.
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Thyroid blood tests
Thyroid blood tests
Thyroid function tests are used to tell whether your thyroid is working normally. The most common thyroid function tests are:Total, or free T4 (the m...
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Head CT scan
or
MRI
to look for pituitary tumor
Head CT scan
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
ImageRead Article Now Book Mark ArticleMRI
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
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Mammography
Mammography
A mammogram is an x-ray picture of the breasts. It is used to find breast tumors and cancer.
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Ultrasound of the breast
Ultrasound of the breast
Breast ultrasound is a test that uses sound waves to examine the breasts.
ImageRead Article Now Book Mark Article - 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
Skin biopsy
A skin lesion biopsy is when a small amount of skin is removed so it can be examined. The skin is tested to look for skin conditions or diseases. A...
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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.
Breast cancer
Breast cancer is cancer that starts in the tissues of the breast. There are 2 main types of breast cancer:Ductal carcinoma starts in the tubes (duct...
Possible Complications
Nipple discharge may be a symptom of breast cancer or a pituitary tumor.
Breast cancer
Breast cancer is cancer that starts in the tissues of the breast. There are 2 main types of breast cancer:Ductal carcinoma starts in the tubes (duct...
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.
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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
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.
