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 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. At 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 non-cancerous?
A number of non-cancerous 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:
o Pituitary gland tumors
o Certain medications, including some hormones and psychotropic drugs
o Some herbs, such as anise and fennel
o 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 non-cancerous 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 almost always occurs with another form of breast