1. Use a Mirror
Stand in front of a full-length mirror, look carefully at both breasts and examine your nipples. It's not necessarily abnormal if one nipple looks different from the other, but be alert for changes in the nipple that are possible signs of a problem. A nipple that becomes inverted, or turned inward, when it is not usually that way, is your signal to call your doctor. She will examine your breasts and order a mammogram or other tests to identify the reason for the inversion. The same goes for a nipple that looks crusted: let your doctor know right away.
2. Check Nipple Discharge
Look for fluid that leaks from one or both nipples. If the fluid leaks only when you press on your nipple, this is called nonspontaneous discharge. This discharge may be clear or cloudy. The fluid also may be colored--yellow, white, green or brown. Nonspontaneous breast discharge does not usually indicate a problem. However, it's wise to have your doctor check your nipples.
A nipple leaking fluid without being pressed is experiencing spontaneous discharge, something common in pregnant and breast-feeding women. If you're neither and you experience spontaneous discharge of fluid or blood, make an appointment with your doctor. While male breast cancer is rare, men should have spontaneous nipple discharge checked to identify the cause.
3. Nipple Tenderness May Mean Infection or a Blocked Duct
A sore, tender nipple on one breast, with the rest of the breast tender, warm and reddened, may indicate a bacterial breast infection called mastitis. This infection often occurs in breast-feeding women. Mastitis is usually accompanied by a fever of more than 101 degrees and may come on suddenly. Sore nipples on one or both breasts can result when a milk duct is blocked or clogged. This is called mammary duct ectasia. Women in their 40s and 50s are most often affected by mammary duct ectasia, possibly due to hormonal changes.
4. Test to Determine the Cause
Your doctor may order a mammogram, ultrasound or breast MRI to identify the cause of a nipple problem, and to rule out breast cancer. If you have nipple discharge, your doctor may take a sample of the fluid to determine whether it contains blood. You also may have a blood test to measure your hormones and determine whether you are pregnant.
Sometimes nipple discharge signals a problem with the pituitary gland, so your doctor may order an MRI of your head to check for a pituitary tumor or other abnormality. Your workup to identify your nipple problem may also include a thyroid test, since a sluggish thyroid gland can cause nipple discharge.
5. Check Your Medicines
Bring your prescription and over-the-counter medicines and supplements to your doctor or pharmacist for review. Certain medications may cause nipple discharge, including some antidepressants, hormones, tranquilizers and blood pressure medications. Herbal supplements with nettle, fennel, thistle, anise and fenugreek also can cause nipple discharge.
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