Nipple discharge

Definition

Clinically significant nipple discharge is the spontaneous, persistent, and nonlactational secretion of fluid (discharge) from the nipple.

Non?clinically significant nipple discharge more commonly occurs in women using contraceptives. Non?clinically significant nipple discharge also occurs in women who are taking medications that have estrogen-like effects on the breast epithelium.


Character of nipple discharge

  • Milky: galactorrhea
  • Purulent (pus): infection
  • Multicolored or sticky discharge: duct ectasia
    Duct ectasia (comedomastitis) appears as burning, itching, and pain associated with palpable subareolar, tortuous, tubular swellings.
  • Serous discharge: intraductal papilloma (usually characterized by nipple discharge without a mass), cysts, or cancer; surgical exploration is imperative.
  • Serosanguineous discharge: intraductal papilloma (usually characterized by nipple discharge without a mass), cysts, or cancer; surgical exploration is imperative.
  • Bloody discharge: intraductal papilloma (usually characterized by nipple discharge without a mass), cysts, or cancer; surgical exploration is imperative.
  • Watery discharge: intraductal papilloma (usually characterized by nipple discharge without a mass), cysts, or cancer; surgical exploration is imperative. Watery discharge is very suggestive of cancer.
  • A green discharge from one breast and especially from one duct is most likely fibrocystic change in the breast.

Bilaterality of nipple discharge

The presence of discharge in one or both breasts could be suggestive of the following diseases although not conclusive.

Unilateral nipple discharge: cancer, infection, cysts, benign growth (papilloma), duct ectasia.

Bilateral nipple discharge: galactorrhea, contraception or estrogen administration

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