Nipple discharge refers to any fluid or other liquid that seeps out of the nipple of your breast. You might have to squeeze the nipple to enable the fluid to come out, or it could seep out on its own. However, in women who aren’t breastfeeding, the sight of nipple discharge can be frightening. A nipple discharge may appear milky, yellow, brown, white, green, bloody, or it may be clear. Non-milk discharge oozes out of your nipple through the same nipple openings that carry milk.
Consequently, experiencing unusual nipple discharge is the third most prevalent reason women visit their doctors for issues related to their breasts. The Journal of Cellular Immunotherapy shows that nipple discharge is the third most reported symptom in the breast after breast pain and a lump or mass. Nipple discharge does not only affect women but men can also be affected.
Furthermore, the consistency of breast or nipple discharge can vary as some may be thick and sticky while others may appear thin and watery. Nipple discharge in men under any circumstances could be an issue and needs a further medical checkup. If you’re not a lactating mother, you should contact your health care provider any time you notice a strange discharge from your nipple. Your symptoms and the results of diagnostic tests will help your doctor determine the optimal treatment for you.
Types of discharges and its symptoms
Nipple discharge comes in many different colors like green, white, clear, brown, or bloody. Its color can give you an insight into the cause. The table below shows the discharge colors and some possible causes in women who are not breastfeeding.
Color Possible cause
|White, yellow, cloudy, or contains pus||Shows an infection of the breast or nipple|
|Brown or cheese-like||Mammary duct ectasia usually blocked milk duct|
|Clear||Breast cancer, especially if it only comes out from one breast|
|Bloody||Breast cancer or papilloma|
Discharge can also take a few different textures like being thin, thick, or sticky.
Symptoms of nipple discharge include:
- Tenderness or feeling of pains around the breast
- Redness of the nipples or breast
- Nipple changes, like dimpling, turning inward, changing color, scaling, or itching
- Lump or protruding in the breast or around the nipple
- Changes in breast size like one breast become bigger or smaller than the other
- Missed periods
- Feeling of fever
- Nauseating feelings or vomiting
Causes of these discharges
Nipple discharge is a normal part of breast function associated with breastfeeding or during pregnancy. It may also be due to menstrual hormone changes and fibrocystic changes. The bloody discharge associated with papilloma can go on its own. This condition may also require evaluation with an ultrasound of the site behind the nipple and areola. Where the ultrasound identifies a lesion within a milk duct, a biopsy will be needed to confirm it’s a papilloma or to exclude cancer.
Sometimes, nipple discharge stems from a benign condition. You can develop breast cancer if you experience any of the following:
- The discharge affects only a single duct
- Only a particular breast is affected
- You have swelling or mass in your breast
- Its discharge is spontaneous and persistent
- The discharge comes with blood
Possible causes of nipple discharge include the following:
- Taking of control pills
- DCIS (ductal carcinoma in situ)
- Breast cancer
- Vigorous breast stimulation
- Endocrine disorders
- Fibrocystic breasts (clustered or rope-like breast tissue)
- Intraductal papilloma (a benign, wartlike growth in the milk duct)
- Trauma or injury to the breast
- Mammary duct ectasia
- Menstrual cycle hormone changes
- Use of certain medications
- Periductal mastitis
- Paget’s disease of the breast
Pregnancy and lactating
The above causes are commonly associated with this symptom. So you are advised to work closely with your doctor for effective diagnosis and treatment.
When to see your doctor
You can make an appointment with your doctor if you experience any of the above symptoms. In the meantime, try to avoid nipple stimulation to check for discharge as stimulation makes the discharge continue.
How to differentiate between normal and abnormal nipple discharge
Can you call a bloody nipple discharge normal? It is definitely an abnormal discharge. Nipple discharge from a particular breast and discharge that occurs spontaneously without you touching, irritating or stimulating the breast are other signs of abnormality.
You are advised never to use color to differentiate between a normal discharge or abnormal discharge. Normal nipple discharge occurs mostly in both nipples and is often produced when the nipples are squeezed or compressed. Some women may be anxious about breast secretions and may cause their condition to deteriorate. This might make them to continuously squeeze their nipples to check for any nipple discharge. Here, to improve its condition, you can allow the nipples to be for a while without forcefully squeezing it.
However, your doctor can help ascertain if your nipple discharge is physiologic (normal) or pathologic (abnormal) using your medical evaluation. Even if your medical doctor identifies your breast discharge not to be normal, have in mind that most pathological conditions that bring about nipple discharge are not severe and are easily treated. Discharge is usually not severe. Still, it can be a sign of breast cancer, so it’s advisable to meet with your doctor for optimal advice and treatment.
What causes normal nipple discharge?
The following might cause normal discharge from the nipple:
Being pregnant: Some women notice clear breast discharge coming out from their nipples usually in the early stages of pregnancy. In the later stages of pregnancy, its discharge may appear milky or watery.
Stimulation: Fluids may come out from your nipples especially when they are squeezed or stimulated. Normal nipple discharge may be found when your nipples are continuously irritated by your bra or during vigorous physical exercise like jogging.
When you stop breastfeeding: It is normal for discharge to still come out from your nipple for a while after you have weaned your baby.
Note: Your breasts each contain approximately 20 milk ducts, and fluid can gush from them. It is normal for some breast milk to leak out of your nipple when you are pregnant or lactating. Breast discharge in men isn’t normal. So you are advised to visit your doctor for a medical examination.
What are the causes of abnormal nipple discharge and can it be noncancerous?
Have in mind that a number of noncancerous conditions can bring about nipple discharge. Where your initial medical evaluation shows that the discharge is abnormal, your doctor may require more tests for you. The tests will help identify the underlying condition that is causing the problem and may involve one or more of the following:
- Performing blood tests or urine tests to check for pregnancy
- Laboratory analysis of the discharge
- A brain scan
- Ductogram. This test uses mammography and an injected contrast material to produce pictures of the milk ducts inside your breasts.
- Mammogram with or ultrasound of one or both breasts
- Surgical removal and analysis of one or more ducts in your nipple
The following are the main causes of abnormal discharge from your nipple:
Galactorrhea. This is a condition in which a woman’s breast produces milk or a milky nipple discharge even when she is not lactating. Although galactorrhea isn’t a disease but has many possible causes which include the following:
Use of certain medications, including some hormones and psychotropic medications.
Pituitary gland tumors
Some herbs like fennel and anise
Taking hard drugs like marijuana
Fibrocystic changes in your breasts. Fibrocystic is simply the presence or development of fibrous cysts and tissue in your breast. These fibrocystic changes in your breasts bring about thickenings or lumps in your breast tissue. This does not mean or show you have cancer. Fibrocystic breast changes can induce pain and itching. But sometimes it can cause the secretion of clear, yellow, white, green, or brown nipple discharge.
Mammary duct ectasia. It’s the second most predominant cause of abnormal nipple discharge. This is usually found in women who are approaching menopause stage. Mammary duct ectasia causes inflammation and possible blockage of ducts found underneath the nipple. When this occurs, an infection may surface that results in thick or greenish nipple discharge.
Presence of infection. Where the nipple discharge contains pus shows you have an infection in your breast. It is also referred to as mastitis. This medical condition is mostly found in lactating mothers. But it can also be seen in non-lactating women. You may notice that your breast is sore, red, or warm to the touch where your breast is being infected.
Intraductal papilloma. They are noncancerous growths in the ducts of the breast. It’s usually the most common reason women develop abnormal nipple discharge. When inflammation occurs, intraductal papillomas may bring about a nipple discharge that contains blood or appears sticky when feeling with the hands.
Are they any connection between nipple discharge and breast cancer?
Yes, they are as most nipple discharge is either normal or caused by a benign medical condition. There are instances, though, where breast discharge may be a symptom of some forms of breast cancer. You’re at a high risk of developing cancer if your nipple discharge is associated with a lump or mass within the breast or if you’ve had an abnormal mammogram. A particular form of breast cancer that may induce breast discharge is intraductal carcinoma. This cancer is formed within the ducts of the breast located below the nipple.
Another rare type of breast cancer that may cause nipple discharge is Paget’s disease. This medical condition develops in the ducts of the breast and then circulates to the nipple. It may cause the nipple and surrounding areola to ooze or bleed profusely. Paget’s disease mostly occurs with another form of breast cancer.
Furthermore, the International Journal of Preventive Medicine deduced that nipple discharge can be a symptom of breast cancer. From this journal, it was estimated that of the women who report nipple discharge of unknown origin, between 7-15% will develop breast cancer.
Do men experience nipple discharge?
Yes, they do. Men should not shy away from consulting their doctor if they experience nipple discharge as it may be associated with various medical conditions, including breast cancer.
The following are the main causes of male nipple discharge:
- Gynecomastia, a medical condition that results in breast enlargement or tenderness
- Testosterone deficiency
- Cancer of the breast
Pituitary tumor, this is because the pituitary gland is responsible for releasing hormones that bring about milk secretion in the nipples
Although this condition is less common in men, a man should never refrain from his doctor if he discovers discharge from his nipples. Babies can also have nipple discharge immediately after birth as a result of the presence of their mother’s hormones that are still circulating in their bodies. However, its side effect usually goes away a few days after birth.
What are its treatment options?
Its treatment options depend on the cause and type of discharge experienced. Usually, doctors will diagnose the underlying cause and then give you the best treatment. This treatment usually resolves the problem.
Is there any link between breastfeeding and breast cancer?
Yes, there is. But it’s still rare to develop breast cancer while breastfeeding your baby. However, there are several other possible causes of breast lumps in breastfeeding mothers.