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Programs & Services

CIBC Breast Centre

Benign Breast Diseases: Nipple Discharge

Nipple discharge may be seen in the following situations:

  • Lactation, normal with pregnancy.
  • Residual nipple discharge that last for several years following weaning from breastfeeding.
  • Endocrine disorders.
  • Drug side effects from oral contraceptives, phenothiazines, methyldopa or cimetidine.
  • Benign breast conditions such fibrocystic condition, duct ectasia, duct papilloma and infection.
  • Breast cancer (if nipple discharge is bloody).

Nipple discharge is more often associated with benign rather than malignant conditions. It is often bilateral and is usually provoked by squeezing or milking the breast. The discharge varies considerably in appearance; it can be milky, clear or watery, yellow, brown, green, dark, blood-tinged or bloody. Spontaneous discharge may appear on and stain night clothing or undergarments.

The majority cases of nipple discharge are non-bloody and are produced by squeezing or milking. These cases are benign and require no treatment, and spontaneous resolution is expected.


Diagnosis

Unilateral, spontaneous, persistent and bloody nipple discharge may require investigation through cytology, hematesting, mammography and galactography (breast duct X-rays). Breast self-examination is also an important skill to acquire.


Treatment

Treatment depends on the cause. Breast biopsy with excision of one or more of the central nipple ducts may be required.


Risk of Breast Cancer

Nipple discharge usually results from benign causes. However, in older women, bloody, unilateral, spontaneous, persistent nipple discharge, with or without the presence of an underlying mass, may be associated with breast cancer or pre-cancerous lesions. These cases will require further investigation and treatment.