Nipple Discharge: Presentations, Causes and Management

Presentations of Nipple Discharge

• Can be from one nipple or both
• Can be from one duct or more
• Can be spontaneous or induced (on squeezing the nipple)
• Can be different colours, milky, cloudy, yellowish, brownish, green, dark, these colours are usually of harmless causes.
• Clear and bloody nipple discharge warrant further investigations

Causes of Nipple Discharge

The causes are many:

• Infection
• Abscess
• Contraceptive pills
• Dilated milk ducts
• Duct papilloma (Papilloma is a wart-like growth of the duct wall protruding in the duct lumen)
• Fibrocystic breasts
• Some medications and other causes
• Invasive and non-invasive types of breast cancer can be the cause of nipple discharge
• Pregnancy, breast-feeding, menstrual and menopausal hormonal changes are causes of nipple discharge

Treatment of Nipple Discharge

• Always get checked, especially when the nipple discharge is either:

→ new

→bloody or clear

→ one breast/ one duct

→spontaneous

• Always get checked if you have a breast lump, pain, changes in breast shape and/or nipple
• You will need Clinical Breast Examination +/- mammogram/ductogram + ultrasound +/- biopsy