The secretion of milk in lactating mothers is a normal and natural form of nipple discharge. However, sometimes an abnormal discharge of either clear or of varying colors is observed in some women, which may be indicative of some underlying medical conditions. An abnormal breast secretion or discharge should not be ignored and the individual should consult a doctor at the earliest.

Breast Secretion or Nipple Discharge: An Overview

Nipple discharge is any kind of secretion noted from the breasts. It is a normal phenomenon in breast feeding women. However, at times breast secretion or nipple discharge can occur in non-breast feeding women too. In such cases, it may be a normal or an abnormal condition. Breast secretion or nipple discharge in men is definitely abnormal. Normal breast secretion or nipple discharge is generally a thin, whitish, cloudy, or nearly clear, non-sticky fluid. The abnormal discharge may be yellow, bloody, green, brown or clear and is usually of concern. The consistency may vary from thick and sticky to thin and watery.

Breast secretion or nipple discharge is commonly seen in women before menopause and is uncommon thereafter. If the discharge is bloody, spontaneous, persistent and one-sided it is a cause of tension and should not be ignored.

Causes of Breast Secretion or Nipple Discharge

Causes of Breast Secretion or Nipple Discharge

  • Normal Causes of Breast Secretion or Nipple Discharge:
    • Pregnancy
    • Breast secretion in some women may continue for up to two years after discontinuing nursing.
    • Vigorous exercises or jogging may stimulate breast secretions.
  • Abnormal Causes of Breast Secretion or Nipple Discharge:
    • Non-Cancerous Papilloma: It is a small benign wart like growth in the ductal lining near the nipple. This leads to bloody nipple discharge. Although harmless, it is good to surgically remove it.
    • Fibrocystic Breast Changes: It refers to the development of fibrous tissue or cysts in breasts. Cysts are the small fluid filled sacs. These changes may cause lumps or thickenings in the breast tissue and do not indicate the presence of cancer. There is usually greenish breast secretion or nipple discharge in this medical condition.
    • Breast Cancer: The abnormal growth of breast cells which is usually seen in the form of a lump. A clear or bloody discharge is observed.
    • Duct Ectasia: When the duct of milk secretion is clogged and swollen, it leads to multi-coloured discharge from nipple. It is a harmless condition.
    • Breast Infection: Pus like discharge due to bacterial infection.
    • Galactorrhea: Even when women are not breastfeeding, the milky secretion from nipples is indicative of a condition called as Galactorrhea. The possible causes of this condition are:
      • Pituitary gland tumors.
      • Certain medications.
      • Hypothyroidism.
      • Illegal drugs.
  • Hormonal Changes Causing Breast Secretion: Breast secretion or nipple discharge could also be due to intake of birth control pills, anti-depressants, tranquilizers, blood pressure medications or ulcer medications.
  • Breast Secretion or Nipple Discharge in Men: In majority of the men, breast secretion or nipple discharge is caused due to breast cancer which is accompanied by a lump.

Early Warning Signs of Breast Secretion or Nipple Discharge

The breast secretion or nipple discharge is not normal when it is associated with the following:

  • A clear discharge oozing spontaneously without squeezing from one breast nipple is an early warning sign.
  • Breast secretion or nipple discharge occurring from one spot of nipple rather than multiple spots.
  • Large amounts of milky discharge are observed when the woman is not lactating is also an early warning sign.
  • Discharge which is clear or of bloody color is of concern as compared to other colors.
  • An abnormal discharge maybe accompanied by dimpled skin, swelling, redness, crusting, sores and a retracted nipple.

Prognosis of Breast Secretion or Nipple Discharge

Most of the times, breast secretion or nipple discharge is unrelated to breast cancer. If detected early, the condition can be resolved with appropriate treatment. However, if breast secretion or nipple discharge turns to be due to breast cancer, depending on its type the prognosis will vary. If breast cancer involves lymph node, then the prognosis may not always be good.

Risk Factors of Breast Secretion or Nipple Discharge

  • Mostly breast secretion or nipple discharge is seen in women over the age of 40-45 years.
  • Smoking increases the risk of developing abnormal nipple.

Complications of Breast Secretion or Nipple Discharge

  • When breast secretion or nipple discharge is accompanied by a lump in the breast, it is possibly due to breast cancer.
  • Intraductal carcinoma wherein the cancer develops within the ducts of nipple.
  • Paget's disease is a rare form of breast cancer, in which the cancer develops in ducts and moves towards the nipples. It causes the area around nipple to bleed.

Diagnosis of Breast Secretion or Nipple Discharge

  • The doctor examines the overall health and records personal medical history of the patient. Hormonal changes and medications if taken are assessed. The breast examination is done to see if the discharge oozes from one or both nipples either spontaneously or by squeezing. The color and consistency of the discharge is also ascertained.
  • When discharge is clear or bloody and oozes continuously from one nipple without squeezing, then it is of major concern since it is due to benign papilloma, although it may not be due to malignancy.
  • Mammography or ultrasound maybe performed to check for any lumps or masses inside the breast.
  • Ductogram is done to look for the source of discharge. It is an X-ray of the ducts in the breast. If any abnormality is seen in the duct, then the patient is operated to remove this growth.
  • If ductogram is not successful then ductoscopy is performed to have deeper look into the ducts of the breast.
  • Biopsy is performed if necessary.
  • Blood tests are done to determine the level of hormones like prolactin and thyroid stimulating hormone.
  • MRI or CT scan is done if brain disorders are suspected.

Treatment of Breast Secretion or Nipple Discharge

Once the cause of breast secretion or nipple discharge is known, the doctors may advise methods of further treatment and management. These may involve:

  • Need to change the medicine which is causing the condition of breast secretion or nipple discharge.
  • The lumps may be surgically removed.
  • Application of topical creams to treat skin changes.
  • Treating the breast infection or mastitis with antibiotics.
  • In case of pituitary gland cancers causing breast secretion or nipple discharge, treatment with certain drugs may be beneficial. It is advised to perform routine breast checks while undergoing treatment.

Prevention of Breast Secretion or Nipple Discharge

  • If breast secretion or nipple discharge occurs due to medications, then one should immediately discontinue those medications.
  • One should not perform rigorous physical exercises if it tends to cause breast secretion or nipple discharge.
  • Regular breast examination is to be done.

Conclusion

Most of the times, the cause of breast secretion or nipple discharge is not carcinogenic. When the discharge is from multiple ducts and occurs from both breasts, it is noncancerous and is hormonal in nature which is treatable. In most of the cases, when the discharge is clear or bloody and occurs from only one breast predominantly in women above the age of 40 years, it is related to malignancy. Thus, one should not ignore it and should seek appropriate medical treatment immediately.

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Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: May 25, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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