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?

Causes

Physiological (normal) discharge

  • Coloured or milky discharge

  • From multiple ducts

  • Usually needs to be expressed & occurs in both breasts

Abnormal Discharge

Duct ectasia

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

  • Can result in a thick, yellow discharge.

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.

Nipple eczema

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

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.

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.