Nipple Discharge

General Information | Risk Factors and Symptoms | Diagnosis and Treatment

General information General Information

About Nipple Discharge

Let your doctor know if you notice any changes in your breasts.

Tiny droplets of fluid may appear on the nipple surface or clothing. There is normally fluid in the milk ducts even if a woman is not pregnant or nursing. Discharge of fluid can be caused by squeezing (such as during a mammogram), sexual stimulation, a warm shower or other pressure to the breast. Breast cancer is an uncommon cause of nipple discharge.

Identifying Abnormal Discharge

Nipple discharge does not always indicate a problem. Further evaluation is necessary when the discharge:

  • Is spontaneous – it comes out by itself without squeezing or nipple manipulation.
  • Comes out of only one opening in the nipple - not multiple.
  • Is bloody, clear or clear-yellow in color (place discharge on a white tissue to check the color).*

* Green, gray or milky discharge does not usually need further breast diagnostic studies. These secretions may be caused by hormonal stimulation, fibrocystic changes, some medications and rarely, a pituitary gland dysfunction.

Risk factors and symptoms Risk Factors and Symptoms

Risk Factors for Nipple Discharge

There aren’t really any risk factors for having nipple discharge. Following are some possible benign (non-cancerous) causes of nipple discharge.

  • Fibrocystic breasts
  • Intraductal Papilloma – noncancerous growth in the ducts of the breast
  • Mastitis, or inflammation of the mammary gland (also causes redness, swelling and tenderness of the breast)
  • Mammary duct ectasia – inflammation and blockage of the ducts under the nipple that occurs in some women near menopause
  • Galactorrhea – a condition where the breast secretes a milky discharge when the woman is not breastfeeding
  • Pregnancy
  • Stopping breastfeeding
  • Stimulation, chaffing, or squeezing
  • Taking certain medications such as birth control pills or sedatives

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Diagnosis and treatment Diagnosis and Treatment

Diagnosing the Cause of Nipple Discharge

A nipple discharge exam called a ductogram may help identify the cause of the discharge.

With this exam, a tiny catheter is placed in the nipple opening where the discharge is seen. Contrast material is injected and then a diagnostic mammogram is performed. The contrast material makes it easier to see abnormalities on the mammogram.

If an abnormality is seen, a breast ultrasound may be performed to further evaluate it.

It’s also possible that a minimally invasive breast biopsy will be done. A biopsy can usually remove and diagnose the problem. The discharge is usually gone after that. Most women have minimal discomfort with this procedure.

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