What women need to know about nipple discharge

nipple discharge

It can be a sign of something bad or nothing at all. Here's what you need to know.

​There is nothing scarier than looking down at your boobs and noticing something coming out of your nipple.

When this happens, your mind starts racing and you leap to the scariest possible conclusion: breast cancer.

But usually, this is NOT the case. Your discharge could indicate breast cancer if only one duct appears to be active, or if the discharge itself seems to contain blood.

By and large, most nipple discharge is usually harmless, caused by trauma, or our shifting hormones. Occasionally benign tumors are to blame, but even that is very rare.

Still, it's hard to think calmly when your usually normal breasts start secreting discharge.

There are many, many reasons your nipples could have decided to act up. If you are concerned, do not pass go, do not collect two hundred dollars, proceed directly to your doctor's office for a consultation.

But to help you start understanding what's going on, here are 16 different reasons your nipples could be discharging.

1. Abscess

A breast or nipple abscess is usually caused by a bacterial infection and results in a build-up of pus that works its way out of your nipple. It can be painful but is easily treated. Specialist Dr. Jack Newman says, "The first thing to say about a breast abscess is that it’s not as bad as many think. It means the mother’s body has partially but not completely successfully fought off the infection."

2. Miscarriage

After a miscarriage, it is totally normal to find discharge coming from your breasts. What you're seeing is colostrum, or, breast milk. Usually, this will stop on its own within a matter of weeks. But, if it continues for more than two weeks you should see a doctor. Dr. Marsha Davis says, "It happens. But if the secretion continues for more than two weeks or if it becomes painful it could indicate an infection and the patient should seek medical attention."

3. Breast infection

Breast infections like mastitis are common in breastfeeding women. Often times discharge from these infections is caused when bacteria from the baby's mouth enter a crack in the skin. Women undergoing menopause also can experience similar infections as their hormone levels change. Dr. John Lumley says, "Women with mastitis often experience a rapid onset physical illness accompanied by strong negative feelings, which leads some women to consider stopping breastfeeding while others are determined to persevere. General practitioners need to provide emotional support for women with mastitis and acknowledge that breastfeeding may be difficult for new mothers."

4. Ductal carcinoma in situ (DCIS)

DCIS was once considered the earliest form of breast cancer, and the easiest to treat. This is when the cancer cells begin inside the ducts of the breasts. Discharge can be a symptom. 60,000 women a year are diagnosed with DCIS and incorrectly think they have full-blown cancer. There has been a growing conversation in the medical community about actually renaming the condition because it is so treatable. "The time is now to discuss a change in the approach to DCIS. We should be demanding change.” – Dr. Laura Esserman, MD, MBA, professor of surgery and radiology at UCSF and Director of the Carol Franc Buck Breast Care Center, UCSF.

5. Excessive breast stimulation

Sometimes after extensive stimulation to the nipples, discharge can occur. It's an easy fix, too. Keeping your hands (and the hands of others) away from your breasts will ease the symptoms entirely. Very often, if you notice discharge and keep checking your breasts for it, this is in and of itself is stimulating the breast tissue. Hold off on checking your breasts for a while and the condition itself may slow or stop entirely.

6. Fibroadenoma

Fibroadenoma is a benign, rubbery feeling, mobile tumors in the breast, commonly found in women in their twenties. Discharge can be a symptom of these tumors. Your doctor will want to biopsy the growth and keep an eye on it, but it is usually nothing to worry about in the long term. "A fibroadenoma is a benign mass of fibrous and glandular tissue. Fibroadenomas are most commonly found in women aged 15 to 35. They increase in size with estrogen stimulation and regress after menopause. These masses can often be felt in the breast and can be seen on ultrasound, mammogram and magnetic resonance imaging. One out of every five women with a diagnosed fibroadenoma has more than one." Says Dr. Otis Brawley. "There are two types of fibroadenomas. They are called simple and complex. Simple fibroadenomas are not correlated with an increased risk of breast cancer and often the only treatment given is the surgical removal of the mass and the routine follow-up that all normal risk women should undergo. It is actually not necessary to remove all of a proven simple fibroadenoma, although most women do want it removed."

7. Fibrocystic breasts

Fibrocystic breasts have lumpy or rope-like textured tissue. During PMS they can be more sensitive than even the average boob during PMS. Discharge with Fibrocystic breasts is not abnormal. "This used to be called fibrocystic breast disease," says sexual health writer Emma Kaywin, "but since it actually isn’t a disease we now just call it what it is — a change. These changes are generally totally benign, but there can be some health challenges associated with them, which is I assume why your doctor told you to keep an eye on how your breast tissue changes moving forward. Here's what you need to know."

8. Galactorrhea

When your nipples are leaking milk or a milky substance outside of breastfeeding, it could be galactorrhea. This is not a disease itself, but often an underlying symptom of another ailment. You should consult a doctor right away. Dr. Kristin Pena says, "Galactorrhea, or inappropriate lactation, is a relatively common problem that occurs in approximately 20 to 25 percent of women. Lactation requires the presence of estrogen, progesterone and, most importantly, prolactin. Stress, suckling, sleep, sexual intercourse, and medications may increase prolactin levels, whereas dopamine inhibits its release."

9. Hormone imbalance

Sometimes hormonal imbalance can lead to nipple discharge. Diseases like PCOS or hypothyroidism could be to blame. Your doctor can run a series of tests to find out if this is the case. Dr. George Dickinson says "The breasts are active organs that change throughout the menstrual cycle and some degree of tenderness and nodularity in the premenstrual phase is so common that it may be considered as normal, affecting perhaps 50-60% of all menstruating women. It rapidly resolves as menstruation starts. It is also called mammary dysplasia and cystic mastopathy."

10. Injury or trauma to the breast

Trauma to the breast like a bruise can lead to swelling and leaking from the nipple. This is a normal part of the healing process of the breast. Blunt trauma can interfere with blood supply to the area and, together with an accumulation of blood due to the bleeding, can disrupt blood supply and result in the “death” of cells in the area including fat cells. This can also result in a hard, painful lump in the breast. The accumulation of blood (hematoma) can also provide a medium for infection to set in.

11. Intraductal papilloma

This is another benign milk duct tumor. It usually appears as one small lump near the nipple with discharge and can be easily removed via outpatient surgery. Your doctor will want to run you through the full gamut of testing to make sure the growth is totally benign. This can include getting a mammogram and having the growth within the duct biopsied. Don't worry, this is all totally normal.

12. Mammary duct ectasia

Mammary duct ectasia happens when a milk duct beneath the nipple thickens, leading to a clogged duct. It is a condition common in women in their 40s and 50s. This is easily treated with antibiotics. Dr. Richard Paullini says, "This is a benign breast disease that can mimic invasive carcinoma clinically. The process that causes the condition is still being debated but histologically it is characterized by dilation of major ducts in the subareolar region. The ducts contain eosinophilic granular secretions and foamy histiocytes. The secretions may undergo calcification and this may be the presenting sign."

13. Medication use

Certain medications like some antidepressants, antipsychotics and even marijuana use can lead to nipple discharge. Talk to your doctor if you have this concern. If you are looking for fixes to this problem, you could try getting rid of caffeine, taking Vitamin E, and Evening primose oil. Again, please consult with your doctor before doing so.

14. Menstrual cycle hormone changes

Fluctuating hormones can lead to discharge from your breasts. If you notice the discharge when you aren't having your period, that's when you should contact a doctor. Doctor Robert Maginini talks about what he looks for when a patient comes in with these symptoms: "If a recent mammogram (last 4-6 months) has not been performed, I will recommend one to help rule out the possibility of cancer as a cause of the discharge. Additionally, ultrasound of the breast is valuable to rule out cancer and will often show evidence of duct ectasia and papillomas."

15. Paget's disease of the breast

Paget's disease of the breast is a rare form of breast cancer is characterized by starting at the nipple, with skin hardening, coloring darkening, and discharge being present from either nipple. It is highly invasive, so contact your doctor post-haste if you are concerned. The National Cancer Institute says, "Malignant cells known as Paget cells are a telltale sign of Paget disease of the breast. These cells are found in the epidermis (surface layer) of the skin of the nipple and the areola. Paget cells often have a large, round appearance under a microscope; they may be found as single cells or as small groups of cells within the epidermis."

16. Prolactinoma

I have this! A prolactinoma is a benign tumor that forms on your pituitary gland and lowers the amount of estrogen in your body, flooding it instead with prolactin, a hormone commonly found in pregnant women. As such, lactation can occur. You can treat it with medication or surgery. Plus you get to tell people you have a brain tumor, which is always a good party stopper.

Bottom line: If you have nipple discharge and you’re not pregnant or breastfeeding, flag it for your doctor. While breast discharge is more likely to be a sign of an infection, hormonal fluctuations, or other benign health issues, it’s always better to be safe.

Diagnosing and Treating Nipple Discharge

Your health care provider will perform a thorough exam and ask you various questions about your symptoms. Depending on the type of nipple discharge you are experiencing and the presence or absence of other symptoms such as redness or pain, some of your breast fluid may be tested for microscopic blood during your exam.

Treatment for nipple discharge varies depending on the underlying cause. Often, warm compresses and antibiotics are all that is needed. In other cases, an abnormal duct may need to be removed surgically.

Talk to your doctor or call the Comprehensive Breast Health Center if you are experiencing any type of unusual nipple discharge.

Geoffrey Nevine — IT Services and IT Consulting

facebook-f messenger twitter pinterest linkedin flipboard instagram youtube whatsapp email

Post a Comment

Post a Comment

Previous Post Next Post