Nipple discharge is usually harmless and does not signify anything seriously wrong. In fact, most women can squeeze some discharge out of their nipples, especially if they have had children in the past. This may be whitish or may be yellow-green or almost black.
On the other hand, nipple discharge can be a symptom of breast cancer, particularly if it is bloodstained. Therefore, you should definitely discuss any nipple discharge with your doctor. If you are a man, you should see your doctor straight away, because the usual cause is a tumour and you will need treatment.
What your doctor will do. Your doctor will check your medication, because some drugs can cause (non-bloody) nipple discharge. The most common culprits are:
cimetidine (for stomach problems)
some antidepressants and other drugs for psychological problems
domperidone (for nausea).
Your doctor will ask whether there is any possibility that you could be pregnant. Some women have nipple discharge very early in pregnancy. Your doctor will then examine your whole breast thoroughly (not just the nipple), to make sure you have no lumps.
Even if you have not noticed any blood, your doctor may ask you to try to squeeze a few drops out, and will test it for microscopic blood.
Each nipple has about 15–20 tiny pores on it. These pores are the openings of ducts that connect with the glandular tissue in the breast. You and your doctor should try to work out whether the discharge is coming from just one pore, or from several.
The cause is very, very unlikely to be breast cancer if the discharge is coming from several pores, it does not contain any blood and you are under 50 years of age.
If the discharge is bloodstained, or it is emerging from just one pore, your doctor will refer you to a hospital clinic for tests (such as ultrasound, mammography and looking at the discharge under the microscope) to make sure that breast cancer is not responsible.
If the discharge is milky and coming from both breasts, your doctor can do a blood test to check for an imbalance of the hormone prolactin.
If all the tests are normal, you can stop worrying, but the discharge may still bother you (perhaps soiling your clothes). A possible cause is some inflammation (mastitis) around the ducts. This is linked with smoking, and may improve if you stop smoking and avoid squeezing. A course of antibiotics may help.
It is possible to have an operation to close or remove the ducts that the discharge is coming from. This operation may not be a good idea for anyone who plans to become pregnant afterwards – depending on the number of ducts involved, it might make breastfeeding difficult and the breast might become congested.
For more information about the breast, look at the section on breast problems.
Written by: Margaret Stearn Edited by: Margaret Stearn Last updated:
Monday, January 16th 2012
GP and broadcaster Dr Phil Hammond shares his views on PIP breast implants and widens the debate on cosmetic surgery. What do you think? We welcome your comments below.