For women who aren't breastfeeding, the sight of nipple
discharge can be alarming. But if you notice discharge from your nipple,
there's no reason to panic. While nipple discharge can be serious, in most
cases, it's either normal or due to a minor condition.
Still, if you are not nursing, you should contact your
health care provider any time you notice breast discharge. Based upon your
symptoms and the results of diagnostic tests, your doctor will decide on the
best course of treatment.
What is normal and what is abnormal nipple discharge?
Bloody nipple discharge is never normal. Other signs of
abnormality include nipple discharge from only one breast and discharge that
occurs spontaneously without anything touching, stimulating, or irritating your
breast.
Color isn't usually helpful in deciding if the discharge is
normal or abnormal. Both abnormal and normal nipple discharge can be clear,
yellow, white, or green in color.
Normal nipple discharge more commonly occurs in both nipples
and is often released when the nipples are compressed or squeezed. Some women
who are concerned about breast secretions may actually cause it to worsen. They
do this by repeatedly squeezing their nipples to check for nipple discharge. In
these instances, leaving the nipples alone for a while may help the condition
to improve.
Based on your medical evaluation, your doctor will determine
whether your nipple discharge is normal (physiologic) or abnormal (pathologic).
Even if your doctor determines your breast discharge is abnormal, keep in mind
that most pathological conditions that cause nipple discharge are not serious
and are easily treated.
What might cause normal nipple discharge?
Some causes of normal nipple discharge include:
Pregnancy: In the early
stages of pregnancy, some women notice clear breast discharge coming from their
nipples. In the later stages of pregnancy, this discharge may take on a watery,
milky appearance.
Stopping breastfeeding: Even after you have stopped nursing your baby,
you may notice that a milk-like breast discharge persists for a while.
Stimulation: Nipples may secrete fluid when they are stimulated
or squeezed. Normal nipple discharge may also occur when your nipples are
repeatedly chafed by your bra or during vigorous physical exercise, such as
jogging.
What causes abnormal nipple discharge and can it be noncancerous?
A number of noncancerous conditions can cause nipple
discharge.
If your initial medical evaluation indicates the discharge
is abnormal, your doctor may ask for more tests. The tests will help determine
the underlying condition that's causing the problem and may include one or more
of the following:
Laboratory analysis of the discharge
Blood tests
Mammogram and/or ultrasound of one or both breasts
A brain scan
Surgical excision and analysis of one or more ducts in your
nipple
Possible causes of abnormal discharge include:
Fibrocystic breast changes: Fibrocystic refers to the presence
or development of fibrous tissue and cysts. Fibrocystic changes in your breasts
may cause lumps or thickenings in your breast tissue. They do not indicate,
though, the presence of cancer. In addition to causing pain and itching,
fibrocystic breast changes can, at times, cause secretion of clear, white,
yellow, or green nipple discharge.
Galactorrhea It might sound scary. But galactorrhea simply
describes a condition in which a woman's breast secretes milk or a milky nipple
discharge even though she is not breastfeeding. Galactorrhea is not a disease
and has many possible causes. These include:
Pituitary gland tumors
Certain medications, including some hormones and
psychotropic drugs
Some herbs, such as anise and fennel
Hypothyroidism
Illegal drugs, including marijuana
Infection Nipple discharge that contains pus may indicate an
infection in your breast. This is also known as mastitis. Mastitis is usually
seen in women who are breastfeeding. But it can develop in women who are not
lactating. If you have an infection or abscess in your breast, you may also
notice that your breast is sore, red, or warm to the touch.
Mammary duct ectasia This is the second most common cause of
abnormal nipple discharge. It is typically seen in women who are approaching
menopause. This condition results in inflammation and possible blockage of
ducts located underneath the nipple. When this occurs, an infection may develop
that results in thick, greenish nipple discharge.
Intraductal papilloma These are noncancerous growths in the
ducts of the breast. They are the most common reason women experience abnormal
nipple discharge. When they become inflamed, intraductal papillomas may result
in nipple discharge that contains blood or is sticky in texture.
What is the connection between nipple discharge and breast cancer?
Most nipple discharge is either normal or caused by a benign
medical condition. There are instances, though, when discharge from the breast
may be a symptom of some forms of breast cancer. This likelihood is greater if
your nipple discharge is accompanied by a lump or mass within the breast or if
you have had an abnormal mammogram.
One form of breast cancer that may cause breast discharge is
intraductal carcinoma. This cancer develops within the ducts of the breast
located beneath the nipple.
Another rare form of breast cancer that may result in nipple
discharge is Paget's disease. This condition develops in the ducts of the
breast and then moves to the nipple. It may cause the nipple and the
surrounding areola to bleed or ooze. Paget's disease usually occurs with
another form of breast cancer.
(WebMD)
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