Brown liquid coming out of breast when squeezed

Breast Biopsies Breast Cancer

What are some common nipple problems?

Table of Contents Show

What are some common nipple problems?
What is ectasia?
Treatment for ectasia
What is intraductal papilloma?
What about other types of nipple discharge?
How is nipple discharge diagnosed?
What color is breast cancer discharge?
Is it normal for breast to discharge when squeezed?
What does discharge from breast cancer look like?

Nipple conditions are a common noncancer (benign) breast condition that affect many women. Some problems are related to lactation. Others are not. Like all breast conditions, any nipple problems should be reported to your healthcare provider right away. This can help you get a prompt diagnosis and start treatment.

What is ectasia?

As a woman nears menopause (around her late 40s or early 50s), the mammary ducts located under the nipple become dilated (widened). This normal process of dilation of the milk gland is called ectasia.

Ectasia is a noncancer breast condition. In some cases, it can lead to a blockage of the ducts. Then fluid may become pooled and leak into the nearby tissue. This causes infection, chronic inflammation, or a pus-filled infection called an abscess. If there is an infection (called periductal mastitis), it may cause scar tissue to form. This draws the nipple inward. This infection may also cause breast pain and thick, sticky nipple discharge.

Treatment for ectasia

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for ectasia generally involves treating the symptoms. This may include warm compresses or antibiotics. In some cases, surgery is needed to remove the affected breast ducts.

What is intraductal papilloma?

An intraductal papilloma is a small, wart-like growth that bumps out into the breast ducts near the nipple. This causes a bloody or sticky discharge. Any slight bump or bruise near the nipple can also cause the papilloma to bleed. If the discharge becomes annoying, the duct can be surgically removed. This can often be done without changing the look of the breast.

Single papillomas most often affect women nearing menopause. But multiple intraductal papillomas are more common in younger women. They often happen in both breasts. Multiple intraductal papillomas are more likely to be linked to a lump than with nipple discharge. Any papilloma linked to a lump is surgically removed.

What about other types of nipple discharge?

Nipple discharge can be alarming to many women. But discharge that occurs only when the nipple and breast are squeezed may not be a cause for concern. The risk of cancer when nipple discharge is the only symptom is fairly low.

A lump with the discharge will be of primary concern to your healthcare provider. But keep in mind that breastfeeding women may experience a lump under the areola, and a discharge. This can be caused by lactational mastitis that occurs with a pus-filled infection (abscess).

Galactorrhea is a milky discharge from both nipples, when a woman is not breastfeeding. This is often due to an increase in the hormone prolactin, which produces milk. Galactorrhea may occur if you take sedatives or marijuana. Or it can be caused by high doses of estrogen. Women who have this often have irregular menstrual periods. Or their periods have stopped. In some cases, galactorrhea may be caused by a pituitary gland tumor. Your healthcare provider may order blood tests and an MRI if he or she thinks you have this.

Nipple discharge that is due to a benign noncancer breast condition may be treated by keeping the nipple clean, among other treatments. Nipple discharge that occurs because of infection may require hospitalization.

How is nipple discharge diagnosed?

Your healthcare provider will likely want to find out if the discharge is coming from 1 duct or several. Multiple duct discharge is nearly always benign. It is likely due to changes such as ectasia. Discharge coming from a single duct may be more significant. But if mammography shows no abnormality, surgery may not be needed.

Nipple discharge can be different colors and textures. Your healthcare provider may take a sample of the discharge and have it checked in a lab to confirm a diagnosis.

Fluid that leaks from one or both nipples is called nipple discharge. Each breast has several (15 to 20) milk ducts. A discharge can come from one or more of these ducts.

Nipple discharge can occur normally during the last weeks of pregnancy and after childbirth when breast milk is produced. A nipple discharge can also be caused by breast stimulation in women who are not pregnant or breastfeeding, especially during the reproductive years. However, a nipple discharge in men is always abnormal.

A normal nipple discharge is usually a thin, cloudy, whitish, or almost clear fluid. However, the discharge may be other colors, such as gray, green, yellow, or brown. A bloody discharge is abnormal.

Abnormal discharges vary in appearance depending on the cause. An abnormal discharge may be accompanied by other abnormalities, such as dimpled skin, swelling, redness, crusting, sores, and an inverted (retracted) nipple. (A nipple is inverted if it pulls inward and does not return to its normal position when it is stimulated.) If a discharge from only one breast occurs on its own (without any stimulation of the nipple), it is considered abnormal.

Several disorders can cause an abnormal discharge.

A discharge from both breasts or from several milk ducts in one breast is more likely to be caused by a problem outside the breast, such as a hormonal disorder or use of certain drugs.

Usually, the cause is a benign disorder of the milk ducts, such as the following:

A benign tumor in a milk duct (intraductal papilloma)
Dilated milk ducts (mammary duct ectasia)

Intraductal papilloma is the most common cause. It is also the most common cause of a bloody nipple discharge when there is no lump in the breast.

Certain disorders stimulate the production of breast milk in women who are not pregnant or breastfeeding (see table Some Causes and Features of Nipple Discharge Some Causes and Features of Nipple Discharge

). In most of these disorders, the level of prolactin (a hormone that stimulates production of breast milk) is elevated. Taking certain drugs can have the same effect.

Cancer causes fewer than 10% of cases.

Nipple discharge is a cause for concern when it

Is accompanied by a lump that can be felt
Is bloody or pink
Comes from only one breast
Occurs without the nipple's being squeezed or stimulated by other means (when it occurs spontaneously)
Occurs in women aged 40 or older
Occurs in a boy or man

If a nipple discharge continues for more than one menstrual cycle or if any of the warning signs are present, women (or men) should see a doctor. Delay of a week or so is not harmful unless there are signs of infection such as redness, swelling, and/or a discharge of pus. Women with such symptoms should see a doctor within 1 or 2 days.

Doctors first ask questions about the woman's symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the discharge and the tests that may need to be done (see Table below).

To help identify the cause, doctors ask about the discharge and about other symptoms that may suggest possible causes. They ask

Whether the discharge comes from one or both breasts
What the discharge's color is
How long it has lasted
Whether it is spontaneous or occurs only when the nipple is stimulated

Women are also asked whether they have had disorders or take drugs that can increase prolactin levels.

Doctors also feel the lymph nodes in the armpits and above the collarbone to check for enlarged lymph nodes.

If doctors suspect that a hormonal disorder is the cause, blood tests are done to measure the levels of prolactin and thyroid-stimulating hormone.

If a pituitary or brain disorder is suspected, magnetic resonance imaging (MRI) or computed tomography (CT) of the head is done.

If the discharge is not obviously bloody, it is analyzed to determine whether it contains small amounts of blood. If blood is present, a sample of the discharge is examined under a microscope (called cytology) to look for cancer cells.

Cysts are drained (by aspiration), and the fluid is tested. If the fluid is bloody, it is checked for cancer cells.

If lumps are solid, mammography is done, followed by a biopsy.

When there is no lump but cancer is still suspected or when other test results are unclear, mammography is done.

If test results after aspiration, ultrasonography, or mammography are abnormal, a biopsy is done.

If ultrasonography and mammography do not identify a cause and the discharge occurs spontaneously and comes from one milk duct, doctors usually do a special type of mammogram (called a ductogram, or galactogram). For this procedure, a contrast agent (which helps make images clearer) is injected into the duct, and images are taken, just as for a regular mammogram. This test can help rule out or identify cancer.

If no lump can be felt and the mammogram is normal, cancer is highly unlikely.

Sometimes a specific cause cannot be identified.

If women have any of the following, they should see a doctor who is experienced in managing breast disorders:

A lump in the breast
A bloody or pink discharge
A spontaneous discharge from one breast
An abnormality previously detected by mammography or ultrasonography

If a disorder is identified, it is treated.

If a noncancerous tumor or disorder is causing a discharge from one breast, the duct that the discharge is coming from may be removed. This procedure requires only a local anesthetic and does not require an overnight stay in the hospital.

Usually, the cause of nipple discharge is not cancer.
If the discharge comes from both breasts or from several milk ducts and is not bloody or pink, the cause is usually a noncancerous hormonal disorder.
If the discharge comes from only one breast and is bloody or pink, cancer is possible, especially in women aged 40 or older.
Whether blood tests, imaging (such as ultrasonography), or both, are done depends on the suspected cause.

What color is breast cancer discharge?

Types and symptoms.

Is it normal for breast to discharge when squeezed?

Nipple discharge refers to any fluid that seeps out of the nipple of the breast. Nipple discharge during pregnancy and breast-feeding is normal. Nipple discharge happens less commonly in women who aren't pregnant or breast-feeding.