Nipple Discharge

 

Nipple discharge is the leakage of fluid from the nipple.

It is very common and not usually a sign of breast cancer.

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Symptoms

Questions your surgeon is likely to ask are:

• How often does it happen?

• Does it discharge from one or both breasts?

• What colour is the fluid?

• Is there ever any blood?​

• Does the discharge happen by itself or do you need to express it?

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Causes

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Physiological (normal) discharge

• Coloured or milky discharge

• From multiple ducts

• Usually needs to be expressed & occurs in both breasts

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Abnormal Discharge

Duct ectasia

• Distension of the ducts behind the nipple, common in post-menopausal women.

• Can result in a thick, yellow discharge.

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Ductal papillomas

• Small growths within the milk duct.

• Can be associated with atypical cells or an increased risk for breast cancer.

• Clear or blood-stained discharge, usually one side only and from single duct.

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Skin Changes

Nipple eczema

• Similar to eczema on other parts of the body, can cause dry skin & weeping.

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Paget's disease

• A particular type of breast cancer that involves the skin of the nipple.

• Itching & crusting of the nipple

• Can be difficult to differentiate from eczema.

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Treatment

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Normal discharge

Normal discharge does not need any treatment.

It will often settle if you stop expressing it.

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Abnormal discharge

This requires further investigation such as mammogram, ultrasound and possibly needle biopsy.

The treatment will depend on the underlying cause and may include surgery.

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Skin changes

Once Paget’s disease has been ruled out, the treatment for nipple eczema is similar to the treatment of eczema in other parts of the body.