Nipple Discharge - Abnormal

Definition

Abnormal nipple discharge is abnormal fluid leakage from one or both nipples of the breast.

Alternative names

Discharge from breasts; Milk secretions; Lactation - abnormal; Witches milk; Galactorrhea

Causes

• A tumor in the brain called a prolactinoma
• A small noncancerous growth in the breast called an intraductal papilloma
• Breast abscess (most commonly seen in women during breastfeeding)
• Breast cancer
• Fibrocystic changes in the breast
• Injury to the breast
• Use of certain drugs including birth control pills, cimetidine, methyldopa, metoclopramide, phenothiazines, reserpine, tricyclic antidepressants, or verapamil
• Widening of the milk ducts (called ductal ectasia)

Considerations

The likelihood of nipple discharge increases with age and number of pregnancies.

While a milky nipple discharge is rare in men and in women who have never been pregnant, it does occur. When it does, it is likely to be caused by some underlying disease, particularly when accompanied by other changes in the breast.

It is relatively common in women who have had at least one pregnancy. A thin yellowish or milky discharge (colostrum) is normal in the final weeks of pregnancy.

The nature of the discharge can range in color, consistency, composition, and may occur on one side or both sides.

"Witch's milk" is a term used to describe nipple discharge in a newborn. The discharge is a temporary response to the increased levels of maternal hormones. Witch's milk should disappear within 2 weeks as hormone levels dissipate in the newborn.

Other nipple discharges can be bloody or purulent (containing pus), depending on the cause.

When to contact a medical professional

Call your health care provider if you have any abnormal nipple discharge.

What to Expect at Your Office Visit

The doctor will perform a physical exam and ask questions about your medical history and symptoms, including:

• Are you pregnant?
• Are you breastfeeding?
• What color is the drainage?
• Does it look like milk?
• Is is bloody?
• Does it look like pus?
• Is the drainage from both breasts?
• How much drainage is there? For example, does it stain or soak a bra or t-shirt?
• Do you examine your breasts? How often?
• What medications do you take?
• What other symptoms do you have? For example, fever, menstrual cycle changes, a breast lump,breast pain, headaches, or vision changes?

Laboratory tests may be done to check prolactin and thyroid levels and to study the cells in the nipple discharge. Other tests that may be done include:

• Breast biopsy (if a lump is found)
• Head CT scan to look for pituitary tumor
• Mammography
• Transillumination
• Ultrasound of the breast

References

Content provided by:

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch). The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Review Date: .5/26/2008

Reviewed By: Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.5/26/2008