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Nipple discharge is a common condition in which fluid leaks from one or both of the nipples either on its own (spontaneous) or only when the nipple is squeezed.
The most concerning type of discharge is spontaneous, bloody or clear (like water) and coming from one nipple. Discharge which is milky or colored (other than red) is considered normal or physiologic and is much more common than bloody or clear discharge. Discharge can be caused by medications, too, but this is a rare cause.
Most Common
- Milky or colorful from multiple openings of one or both nipples, usually with nipple manipulation
- Not associated with a lump
- Small amounts of fluid usually before the menstrual cycle or in women on hormone replacement therapy
- During or immediately after pregnancy
- Fibrocystic changes in the breast is the most common condition
Most Dangerous
- Bloody or watery discharge from one nipple occurring without manipulation
- Persists throughout entire menstrual cycle
- Associated with a mass
- Caused by non-cancerous tumors called papillomas much more commonly than cancerous tumors
- Milky discharge is rarely caused by a tumor (usually benign) in the pituitary gland
Caused by Medications
- A variety of medications can cause nipple discharge
- Review medications with your prescribing clinician before stopping any prescription medications
Treatment
- No specific treatment if the discharge is determined to be physiologic or caused by ‘fibrocystic changes'
- Stopping medications under the direction of your prescribing clinician
- Diagnostic imaging including mammography (with or without xray dye), ultrasound and/or breast MRI may be necessary to pinpoint the cause of the discharge
- Surgical removal of a tumor (if found) or removal of the ductal system demonstrating discharge may be necessary
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The Breast Care Center provides screening and diagnostic mammography, breast MRI and ultrasound, as well as breast biopsies including ultrasound, stereotactic and MRI-guided biopsies. The best approach to providing the highest-quality breast care is the integrated approach, where all services - from cancer screeening through treatment - are in one place. Quality service, continuity of care, communication among physicians and patient satisfaction all are better when a patient can receive all the care she needs in one place.
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