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Nipple Discharge

Nipple discharge is the leakage of fluid from the nipple.

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

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

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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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.

Treatment

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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