Have you ever had a nipple discharge? If so, it was probably an alarming experience.
You may be comforted to know that it is a common experience for women, however.
Nipple discharge is the third most common breast-related medical complaint women
bring to their doctors, after lumps and breast pain. But while these discharges
are common, they are not "normal". While it's typical to worry about breast
cancer, the good news is that 9 out of 10 times, these discharges result from
benign (non-cancerous) conditions.
It's impossible for a doctor to say what's causing your discharge without evaluating
both you and the discharge. If you have a discharge, your physician 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 it? A milky discharge is usually from
an elevated level of the hormone prolactin. In evaluating a breast discharge,
your doctor may 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 pills may also increase prolactin levels. If you have an elevated
prolactin level, don't assume you'll need brain surgery: many of these tumors
can safely and successfully be treated with medication.
Another cause of milky white nipple discharge is nipple stimulation from fondling,
suckling or even irritation from clothing during exercise or activity.
Most bloody or watery nipple discharges result from a benign condition such
as papilloma or from an infection. A papilloma is a non-cancerous, wart-like
tumor with a stalk which grows 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.
Nipple discharge does not just affect women: men may have nipple discharge
as well. Both male and female adolescents may experience a benign milky discharge
during puberty. In adults, however, nipple discharge in men is more often associated
with cancer than in women.
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Created: 10/2/2003  - Donnica Moore, M.D.