What Is Nipple Discharge?

Discharge or leakage of fluid from the nipple – while not common – is certainly disconcerting. We’ve mentioned the topic of nipple discharge in the past, and thought we would discuss the specifics in more detail this week.

First, we start with the basics of what is nipple discharge. Nipple discharge is the leakage of fluid from the nipples. This can occur from one or both nipples from one or more of several ducts that end there. While nipple discharge can be seen with breast cancer – relax. Most patients with breast discharge will have benign, noncancerous causes for their condition.

There are many different causes and reasons for breast discharge, some of the more common of which we will explore over the next few posts. The first step to sorting out the causes is to fully characterize what is leaking and how:

• Is the discharge spontaneous or does it occur only with squeezing the breast or nipple?

• From both breasts or one?

• What color is the breast discharge?

• Is it clear or milky?

• Is the discharge dark or bloody?

Make an appointment to see your doctor if you have new breast discharge that persists for longer than a month if you are premenopausal or if you have any breast discharge and are postmenopausal. Your doctor will consider the above questions and will begin with a clinical breast exam. Imaging with your friendly radiologist may be the next step.

Imaging will often start with a diagnostic mammogram. Breast ultrasound may be requested, with special attention paid to the ducts which are usually largest and best seen beneath the nipple. A special procedure called a ductogram involves injecting a small amount of contrast material into the duct which is leaking with imaging with mammography after the injection. This can find small masses in the ducts that can sometimes be the reason for discharge. Breast MRI may also be used in some cases, and will also involve an intravenous injection of contrast material.

Don’t be surprised if the evaluation turns up nothing – many times the reason for breast discharge is not found and the condition resolves without any treatment on its own. We hope this exploration of breast discharge will leave you informed and empowered. The more you know, the better you can help your healthcare provider take care of you!

Originally published 1/20/14 on mammographykc.com.