Nipple Discharge

Nipple discharge is a common breast symptom which is only infrequently a sign of breast cancer. Some small amount of nipple discharge can be entirely normal particularly for up to a year (or even more) after stopping breast feeding. Many women can produce a small amount of nipple discharge if they squeeze their nipples firmly (not advised). This is due to a small amount of fluid that is produced naturally within the milk ducts.

More copious nipple discharge, or the sudden onset of nipple discharge where this had not occurred before, should be checked out. The commonest cause are inflammation of the milk ducts in the breast or a small harmless warty growth (often only just the size of a pinhead and termed a papilloma), within one of the milk ducts. If the discharge is due to inflammation of the milk ducts it is often occurs on both sides and may vary in colour from clear through to white, brown or even green. In these cases the discharge will frequently be visible as 2 or 3 drops of fluid on the tip of the nipple when the breast is squeezed. This should be contrasted to discharge caused by a duct papilloma which usually causes clear discharge coming from only one breast and from only one small duct opening on the nipple. Both of these causes of nipple discharge can lead to blood staining though this can also be associated with breast cancer and it is particularly important that this symptom is checked out quickly if you are aware of any blood within the discharge. It has to be emphasised that in the majority of cases, even with blood staining, that breast cancer is not the cause of the discharge.

Nipple discharge is usually investigated with a mammogram, an ultrasound and by analysis of a small drop of fluid under a microscope Sometimes it is necessary to carry out a small operation to remove one or more of the breast ducts for analysis in order to be absolutely certain of the cause of the discharge. A very new development is this field is breast duct micro-endoscopy. In this procedure a small camera is passed down through the natural opening in the nipple and the inside of the milk ducts are visualised. This can sometimes establish diagnosis without resort to surgery. Breast duct micro-endoscopy is only available in the UK at the London Bridge Hospital.

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