Nipple Discharge

What is nipple discharge?

Nipple discharge is fluid that comes out of your nipple. Each of your nipples has tiny openings that fluid can pass out of. Most nipple discharge is not serious. However, any discharge should be checked by your healthcare provider.

How does it occur?

Nipple discharge usually has a normal cause. For example

• You may have a clear, straw-colored discharge in early pregnancy.
• You may have a thin, milky discharge when you are pregnant, while you are breast-feeding, and for a while after you finish breast-feeding.
• You may have some clear or thin milky discharge when your breasts are stimulated or when you wear a poorly fitted bra, especially if you jog, do aerobics, or lift weights.

Sometimes discharge may be caused by medicines or it may be a symptom of another problem. For example:

• When you are not pregnant or breast-feeding, you may have a whitish or greenish discharge. It may be caused by some medicines, such as birth control pills. It may also be caused by a hormone imbalance, thyroid disease, a tumor in the pituitary gland, or a cyst under the darkened area around the nipple.
• Discharge with pus may be caused by infection.
• Bloody discharge may be caused by abnormal breast tissue. It might be caused by a tiny, noncancerous tumor growing in a milk duct (called intraductal papilloma) or by breast cancer.
• A hard blow to the chest may cause a clear, yellow, or bloody discharge. The discharge may be caused by dying fatty tissue in the breast. In this case, the dying fatty tissue will feel like a lump and you may need a biopsy to make sure the lump is not caused by cancer.
• Chemotherapy sometimes causes nipple discharge.

How is it diagnosed?

Your healthcare provider will examine your breasts. Your provider will also ask about your medical history. He or she will ask if you have stopped having menstrual periods, are having trouble getting pregnant, or are having headaches or vision problems. Your provider will also ask about what medicines you are taking.

The color and consistency of the discharge, as well as whether it comes from 1 or both breasts, help your healthcare provider know what is causing it.

You may have the following tests:

• lab tests of the discharge
• blood tests
• mammogram (X-ray of the breasts)
• ultrasound scan of your breasts
• CT scan (computerized X-rays) of your brain to look at your pituitary gland and hypothalamus
• MRI scan of the breasts
• biopsy of lumps

How is it treated?

The treatment depends on the cause. Sometimes no treatment may be needed.

If you are pregnant, the discharge will stop soon after you deliver unless you are breast-feeding.

Possible treatments for other causes are:

• taking medicine or stopping a medicine you have been taking
• surgery, for example, to remove a cyst
• radiation therapy, surgery, or chemotherapy if cancer is the cause

How long will the effects last?

Nipple discharge not caused by pregnancy or breast-feeding may last until the problem causing the discharge is found and treated. If no cause for the discharge can be found, your healthcare provider will examine you at regular checkups to see if anything has changed.

How can I take care of myself?

• Follow your healthcare provider's instructions and keep your appointments for checkups.
• Check regularly for any changes in your nipples and any change in the fluid that leaks out. Report any changes to your provider.