Topic 09

Nipple discharge

Nipple discharge is one of the complaints that worries women most. What decides the assessment is not how much there is, but what kind it is.

A general view of the consulting room

Which kinds are harmless

White, yellow or green discharge that comes from both breasts, from many ducts, and only on squeezing is usually hormonal in origin. A raised prolactin level and thyroid disorders are common causes of this picture, and its link to cancer is rare.

The discharge that needs investigation

Discharge from one breast, from a single duct, appearing on its own — that is, without squeezing — is assessed differently. Bloody, clear watery or brown discharge in particular must be investigated.

The most common cause of this kind of discharge is an intraductal papilloma: a benign, wart-like growth inside a milk duct. Rarely, cancer can also announce itself this way.

Diagnosis and treatment

Alongside examination, ultrasound and — depending on age — mammography are used; some patients need further imaging.

Treatment is the removal of the duct the discharge comes from, through a small incision. This is both diagnosis and treatment: the tissue removed goes to pathology, and the discharge stops.

Appointment

Do not wait on bloody discharge

Spontaneous bloody discharge from one breast usually turns out to be benign, but it is a finding that has to be investigated.