Nipple Discharge

Comprehensive Breast Care

The most common breast problems seen in consultation with a breast specialist are:

Nipple Discharge

Nipple discharge is not uncommon, and with the right treatment and care it can be remedied. Our Boulder center is here to help. Nipple discharge is the spontaneous release of secretions through the nipple. It is a normal function of the female breast in child-bearing years (puberty through menopause).

Nipple discharge can be:

  • Clear (serous)
  • Milky or cloudy
  • Green or yellow
  • Bloody (pink or red)
  • Brown or black

In non-breast feeding women, normal discharge is bilateral (both breasts), from multiple ducts, and can be manually expressed. Abnormal discharge is often unilateral (one breast), from a single duct, and is released spontaneously or intermittently.

Normal discharge is not a sign of breast cancer, but may be a sign of a hormonal imbalance or change. Abnormal discharge represents a breast cancer in only 10% of cases (only 3% of breast cancers present with abnormal nipple discharge). This must be evaluated by a physician for proper diagnosis.

Concerning nipple discharge is often bloody (including brown and black) or clear. This is frequently caused by a non-cancerous growth within a milk duct (papilloma) or a chronically dilated milk duct (duct ectasia). It may also be caused by a persistent abscess near the nipple.

Physical exam and imaging studies may identify a dominant mass or area of concern that is contributing to the abnormal discharge. Further workup, including specialized imaging studies (mammogram, ultrasound, and/or MRI) are often required.

These findings will help determine whether a biopsy procedure is warranted. If an area of concern is identified with imaging studies, it can often be biopsied through non-surgical techniques initially. If no dominant mass or area in the breast is identified, an open surgical biopsy is sometimes warranted. During this procedure the involved breast duct is removed using direct visualization in the operating room.

Some women present with large quantities of milky discharge know as “galactorrhea.” This is usually bilateral and from multiple different milk ducts. It is the result of overproduction of prolactin, a pituitary hormone. The workup involves looking for a pituitary (brain) tumor, underactive thyroid disease (hypothyroidism) as well as a side effect from various different medications. It is managed medically, often by an Endocrinologist.

Treatment Options for Nipple Discharge

  • Clinical Follow-up
  • Occasional Laboratory Testing
  • Advanced Imaging Studies
  • Watchful Waiting Versus Biopsy

Our goal is to coordinate and expedite your care so that you can focus on healing and enjoying your life. Please call us today at 303‑449‑3642 to schedule an appointment or ask a question. The entire Boulder Breast Center team is here to help.