About Nipple Discharge

Tiny droplets of fluid may appear on the nipple surface or clothing.

There is normally fluid in the milk ducts even if a woman is not pregnant or nursing. Discharge of fluid can be caused by squeezing (such as during a mammogram), sexual stimulation, a warm shower or other pressure to the breast. Breast cancer is an uncommon cause of nipple discharge.

Identifying Abnormal Discharge

Nipple discharge does not always indicate a problem. Further evaluation is necessary when the discharge:

  • Is spontaneous – it comes out by itself without squeezing or nipple manipulation.
  • Comes out of only one opening in the nipple – not multiple.
  • Is bloody, clear or clear-yellow in color (place discharge on a white tissue to check the color).*

* Green, gray or milky discharge does not usually need further breast diagnostic studies. These secretions may be caused by hormonal stimulation, fibrocystic changes, some medications and rarely, a pituitary gland dysfunction.

Risk Factors and Symptoms

Risk Factors for Nipple Discharge

There aren’t really any risk factors for having nipple discharge. Following are some possible benign (non-cancerous) causes of nipple discharge.

  • Fibrocystic breasts
  • Intraductal Papilloma – noncancerous growth in the ducts of the breast
  • Mastitis, or inflammation of the mammary gland (also causes redness, swelling and tenderness of the breast)
  • Mammary duct ectasia – inflammation and blockage of the ducts under the nipple that occurs in some women near menopause
  • Galactorrhea – a condition where the breast secretes a milky discharge when the woman is not breastfeeding
  • Pregnancy
  • Stopping breastfeeding
  • Stimulation, chaffing, or squeezing
  • Taking certain medications such as birth control pills or sedatives

Diagnosis and Treatment

Diagnosing the Cause of Nipple Discharge

A nipple discharge exam called a ductogram may help identify the cause of the discharge.

With this exam, a tiny catheter is placed in the nipple opening where the discharge is seen. Contrast material is injected and then a diagnostic mammogram is performed. The contrast material makes it easier to see abnormalities on the mammogram.

If an abnormality is seen, a breast ultrasound may be performed to further evaluate it.

It’s also possible that a minimally invasive breast biopsy will be done. A biopsy can usually remove and diagnose the problem. The discharge is usually gone after that. Most women have minimal discomfort with this procedure.

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