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Breast Discharge

Q: As I was getting into the shower last week, I noticed a milky white, sticky discharge coming from my breasts. I'm not pregnant. In fact, it happened during my period, so it's definitely not lactation. Now that I've finished menstruating the discharge does seem less heavy, but it hasn't stopped entirely. Is this normal?

Dr. Donnica: It's impossible for me to say what it is without evaluating you and the discharge. Nipple discharges are very common and most are benign (not associated with cancer). They are not "normal," however, and must always be evaluated by your physician who will probably do a thorough breast exam and try to express some of the material to send it for a Pap smear.

What could be causing this? With a milky discharge, it's usually a hormonal imbalance. As a result, your doctor may also recommend a blood test to measure your prolactin level. Prolactin is a hormone produced by the pituitary gland, which is responsible for lactation. Some pituitary tumors, even tiny ones called microadenomas, can cause excess prolactin secretion that can lead to milky nipple discharge, usually from both breasts. Some medicines such as those for depression, anxiety, hormone replacement or birth control may also cause increased prolactin levels.

Most bloody or watery nipple discharges result from a benign condition such as papilloma or infection. A papilloma is a non-cancerous, wart-like tumor with a stalk that has grown inside the breast duct. Other benign conditions that cause suspicious nipple discharge include fibrocystic conditions or duct ectasia (widening and hardening of the duct due to age or damage). A nipple discharge is more likely to be of concern if it is bloody or watery with a red, pink, or brown color; if it is sticky and clear or brown to black in color; if it appears spontaneously without squeezing the nipple; if it is persistent; if it occurs only on one side; or if it is a fluid other than breast milk.

Created: 10/19/2003  -  Donnica Moore, M.D.

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