Nipple discharge
Fluid from the nipple, often benign but sometimes indicating disease.
Wikipedia / Wikimedia Commons
Nipple discharge is fluid that comes from the nipple, either on its own or when the breast is squeezed. The fluid can appear milky, clear, green, pus-like, bloody, or faintly yellow, and its texture may be thick, thin, sticky, or watery. This symptom is the third most common breast-related concern among women, following breast pain and a breast lump.
Some discharge is normal. For example, milky fluid is typical during late pregnancy, after childbirth, and while breastfeeding. Newborns may also leak a milky liquid for a few weeks, which is usually harmless. In healthy women of reproductive age, squeezing, massage, breast pump use, or mammography can trigger yellow, milky, or green discharge.
Discharge is considered abnormal if it happens in men, appears spontaneously without pregnancy or lactation, is crystal clear or blood-stained, comes from only one breast, or occurs alongside a breast lump, swelling, redness, or skin changes. Causes of abnormal discharge include a blocked or enlarged milk duct, intraductal papillomas (non-cancerous growths most common in women aged 30 to 50, often causing bloody or straw-colored discharge), duct ectasia (common in perimenopausal and menopausal women, sometimes with pain or nipple retraction), infection (mastitis or breast abscess), eczema of the nipple, and breast cancer—including Paget’s disease, which may cause bloody discharge. Ductal carcinoma in situ (DCIS) in men often presents with nipple discharge, while in women it typically shows up on mammography.
Milky discharge in a woman who is not pregnant or breastfeeding is evaluated separately. The cause can often be identified without tests. If blood tests are done, they usually check thyroid function and prolactin levels to rule out hypothyroidism or hyperprolactinemia. Other possible tests include mammography, breast ultrasound, CT scan of the head (to check for a pituitary tumor), breast biopsy, X-ray imaging of the breast ducts, or skin biopsy. Testing is more likely if the discharge is bloody, from one breast, and the woman is over 50. Cytology of the discharge is not routine because a negative result does not rule out cancer, but if malignant cells are found, cancer is highly likely.
Conditions that raise prolactin can cause milky discharge.
Quick Facts
- Field
- Gynecology
- Types
- Physiologic, pathologic
- Diagnosis
- Normal: Late pregnancy, after childbirth, newborns / Abnormal: Intraductal papilloma, duct ectasia, blocked milk duct, infected breast, breast cancer, high prolactin
- Treatment
- Depends on the cause
- Frequency
- Common
Facts from the source article.
Lore & Background
Nipple discharge can be normal, such as milky fluid in late pregnancy, after childbirth, or in newborns during the first weeks of life. It may also be normal following breast stimulation in women during reproductive years. Abnormal discharge occurs in men, contains blood, comes from only one breast, or is associated with a breast lump, swelling, redness, or skin changes. Causes include intraductal papilloma, duct ectasia, blocked milk duct, mastitis, breast abscess, breast cancer, certain medications, and conditions that raise prolactin.
Reader's Guide
Nipple discharge is a common symptom that requires careful evaluation to distinguish normal from pathological causes. While most cases are benign, about 3% of breast cancer cases present with discharge, making it a significant clinical sign. Diagnosis often involves blood tests for thyroid and prolactin levels, mammography, breast ultrasound, or biopsy. Treatment depends on the underlying cause, ranging from antibiotics for infection to surgical duct excision for duct ectasia. The condition highlights the importance of thorough breast examination and appropriate testing, especially in cases of unilateral, bloody, or spontaneous discharge, or when it occurs in men.
Did You Know?
- Nipple discharge is the third most common breast complaint by women, after breast pain and a breast lump.
- About 3% of breast cancer cases are associated with nipple discharge.
- Milky discharge in a non-pregnant, non-breastfeeding woman is evaluated differently from other abnormal nipple discharge.
- Some herbs including anise and fennel have been implicated as causing nipple discharge.
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