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Is Nipple Discharge Concerning in a Non-Pregnant Woman?

If you’re a women and experiencing Nipple Discharge, especially if you aren’t pregnant, the first instinct you might have is that something is seriously wrong. Cancer is often the first place the mind goes. But truthfully, there is no reason to hit the “panic” button to soon. It’s important to realize that most nipple discharge isn’t concerning. That doesn’t mean it won’t be bothersome or embarrassing.

Often, the first thought is Breast Cancer, but there are far more likely causes.

If you aren’t Pregnant or nursing, it’s still important to contact your healthcare provider because additional testing and/or examination is likely required. Depending on other symptoms, including medications, other medical conditions, recent illnesses, examination and other evaluation processes – these will help determine a course of treatment.

Questions you need to ask yourself?

1.)  Is the discharge from one Breast or both?
2.)  What color is the discharge?
3.)  Does it have a smell?
4.)  Do you have breast redness that coincides with your discharge?
5.)  Does discharge only happen with touching or stimulating breast?
6.)  Does discharge happen on its own?

What is normal breast discharge?

1.)  Pregnancy
–  Early stages of pregnancy can lead to some clear nipple discharge
–  This happens in the months leading up to delivery.
–  Late stages of pregnancy can lead to a milky or watery appearance
–  This happens in the weeks leading up to delivery.

2.)  Breast feeding
–  This can be normal due to breastfeeding
–  But if the color changes, redness of the breast is noted, and/or serious irritation – you may need to stop breastfeeding for a period of time.

3.)  Stimulation
–  Fluid may be secreted when nipples are stimulated or squeezed
–  This varies from individual to individual.
–  This also includes possible discharge after chafing following vigorous exercise or irritation from your bra.

Possible Causes for Abnormal breast discharge

Typically the cause is non-cancerous so we will start there.

1.)  Infection
–  The discharge may be dark-colored or otherwise
–  Also known as Mastitis
–  Can be seen in women breastfeeding
–  Can also be seen in non-breastfeeding women
–  She can have an abscess in her breast.
–  The breast may be sore, red, swollen, and warm to the touch.

2.)  Fibrocystic breast changes
–  The presence of fibrous tissue or cysts  (Breast Fibroadenoma)
–  Causes lumps in breast tissue
–  Non-cancerous finding
–  Can be slightly painful or itching.
–  Can cause secretion of a clear, white, yellow, or green nipple discharge.

3.)  Galactorrhea
–  The process of when a women secretes milk even when she is not pregnant or breast feeding.
–  Has many different causes:  Some medications, Pituitary gland tumors, some herbs, some drugs including marijuana.

4.)  Mammary Duct Ectasia
–  Second most common cause
–  Often seen in women approaching Menopause
–  Inflammation process that may block the ducts under the nipple
–  An infection develops that results in thick, greenish nipple discharge.

5.)  Intraductal Papilloma
–  Non-cancerous growths of the ducts of the breasts.
–  Most common cause of abnormal nipple discharge.
–  Discharge may contain Blood and be sticky in texture.

Nipple Discharge and Cancer

In some cases – the discharge may be a rare sign of cancer. Often, another problem is the cause. However, Cancer is something that needs to be considered.

If you have a hard lump or mass in your breast and discharge – testing and evaluation is necessary.  You should seek a provider who can perform a physical exam. A Mammogram is often an essential piece of the process.

Possible Types of Cancer with Discharge

Intraductal Carcinoma
–  One type of breast cancer that can have nipple discharge
–  It develops in milk ducts found beneath the nipple.

Paget’s Disease
–  Also found in the breast ducts
–  It then moves to the nipple.
–  It can cause the Areola and surrounding areas to bleed or ooze.

Possible Evaluation tests

–  Lab/Blood work testing
–  Culturing Discharge
–  Breast Ultrasound
–  Breast Mammogram
–  Brain scan
–  Fine needle biopsy
–  Surgical examination/excision
–  Others

Newer Evaluation processes that are being studied/evaluated

1.)  Ductoscopy
–  Newer technology that allows visualization of the breast ducts
–  Can be done in the office
–  A complete role not completely clear

2.)  Ductal Lavage
–  Newer technology that evaluates a large sample of cells that are washed out (lavaged) from the ducts.
–  Can be costly
–  Unsure the effectiveness of this procedure.

Also look at the following links

Facts About Breast Cancer

Breast Cancer Awareness Month

Self Breast Exams