Breast Nipple Discharge – Should I Be Concerned?

Breast Nipple Discharge is the third most common breast complaint for which women seek medical attention.

Nipple discharge can be troublesome and annoying, but is rarely a sign of a serious disease. Any fluid leaking from the nipple, including milk, is considered nipple discharge. Nipple discharge can occur most of a woman’s life, and increases with age and number of pregnancies.

Nipple discharge in men is rare, but more often associated with malignancy.

Be concerned if nipple discharge is:

  • Bloody or watery with a red, pink, or brown color
  • Spontaneous (appears without squeezing the nipple)
  • Persistent
  • On one side only (unilateral)
  • Associated with other breast symptoms (lumps, skin changes, nipple inversion)

What to do if concerned:

Women should report any suspicious nipple discharge to their physician. A breast examination should be performed, and if any discharge can be produced during the exam it may be sent for cytology (nipple smear) and hemoccult to check for the presence of blood. A simple blood test may be necessary to check hormone levels (prolactin and TSH). If the patient has a mass in addition to nipple discharge, mammographic evaluation, additional adjunctive imaging, or biopsy may be required.

Conclusions:

Although nipple discharge is rarely cancerous, women should not hesitate to seek medical attention to discuss the type, possible causes, and treatment options available. Our approach incorporates any relevant history, the character of the discharge, and examination of any evidence of underlying pathology. Breast exam, mammography, and directed ultrasound are done first. If indicated, breast MRI can be useful as well. Ultrasound guided biopsy or ductal exploration may be performed for any suspicious findings.

 


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