Nipple Discharge

The breast is a milk-producing gland, which responds to hormones and stimulation.  Discharge from one or both nipples is a very normal finding.  It is very rare that nipple discharge is related to breast cancer.

Nipple discharge is most concerning when it comes out by itself (without squeezing), keeps occurring, is only from one nipple and usually one duct, and is bloody or clear and sticky. 

WHAT CAN CAUSE NIPPLE DISCHARGE?

History of breastfeeding:  Some women produce a milky discharge months and sometimes years after having finished breastfeeding.

Stimulation:  Squeezing or expressing the breast or nipple can produce a nipple discharge.

Fibrocystic breast changes:  Cysts (sacs filled with fluid) and/or fluid build-up in the ducts near the nipple can cause nipple discharge that is  yellowy-green in color.

Intraductal papilloma:  This small benign (non cancerous) wart-like growth in the duct lining may become irritated and bleed, producing a brown or bloody discharge.

Hormonal changes:  A milky discharge that occurs in both breasts in a woman who is not breastfeeding may be due to increased levels of the hormone prolactin.

Breast cancer:  This can very rarely cause a bloody or clear nipple discharge.

WHAT IS DONE TO INVESTIGATE NIPPLE DISCHARGE?

Your doctor will take a thorough breast health history and family history and then examine your breasts.

Your doctor will want to know:

• the color and consistency of the discharge
• the amount of discharge
• how often the discharge occurs
• if the discharge comes out by itself or when squeezed from the nipple
• if the discharge comes from one or both nipples

A mammogram and/or an ultrasound specifically checking the area behind the nipple is often done. 

A special mammogram, called a Galactogram, can be done to identify anything that is not normal inside the discharging duct.  

A sample (smear) of the discharge fluid placed on a glass slide may be taken and sent to the lab to be examined.

For women with milky discharge, a special blood tests to rule out a prolactin hormone imbalance may be done.

WHAT IS THE TREATMENT?

In some cases, surgical removal of the involved discharging duct may be recommended.

It is important to avoid squeezing your nipples.  This will stimulate hormones which, in turn, will create more discharge.