For women who aren't breastfeeding, the sight of nipple discharge can be alarming. But if you notice discharge from your nipple, there's no reason to panic. While nipple discharge can be serious, in most cases, it's either normal or due to a minor condition.
Still, if you are not nursing, you should contact your health care provider any time you notice breast discharge. Based upon your symptoms and the results of diagnostic tests, your doctor will decide on the best course of treatment.
By Amy Engeler
At 3 a.m., with all the houses dark up and down her winding suburban street in West Warwick, Rhode Island, Jo-Ann Frey, 37, lights a candle so she can see well enough to dust her furniture. Careful not to turn on any lights or make noise that might wake up her family, she drifts from room to room with her candle and cleaning supplies, waiting until she feels sleepy enough to climb back into bed. That feeling doesn't come -- and when she hears the alarm in the bedroom go off...
What is normal and what is abnormal nipple discharge?
Bloody nipple discharge is never normal. Other signs of abnormality include nipple discharge from only one breast and discharge that occurs spontaneously without anything touching, stimulating, or irritating your breast.
Color isn't usually helpful in deciding if the discharge is normal or abnormal. Both abnormal and normal nipple discharge can be clear, yellow, white, or green in color.
Normal nipple discharge more commonly occurs in both nipples and is often released when the nipples are compressed or squeezed. Some women who are concerned about breast secretions may actually cause it to worsen. They do this by repeatedly squeezing their nipples to check for nipple discharge. In these instances, leaving the nipples alone for a while may help the condition to improve.
Based on your medical evaluation, your doctor will determine whether your nipple discharge is normal (physiologic) or abnormal (pathologic). Even if your doctor determines your breast discharge is abnormal, keep in mind that most pathological conditions that cause nipple discharge are not serious and are easily treated.
What might cause normal nipple discharge?
Some causes of normal nipple discharge include:
Pregnancy. In the early stages of pregnancy, some women notice clear breast discharge coming from their nipples. In the later stages of pregnancy, this discharge may take on a watery, milky appearance.
Stopping breastfeeding. Even after you have stopped nursing your baby, you may notice that a milk-like breast discharge persists for a while.
Stimulation. Nipples may secrete fluid when they are stimulated or squeezed. Normal nipple discharge may also occur when your nipples are repeatedly chafed by your bra or during vigorous physical exercise, such as jogging.
What causes abnormal nipple discharge and can it be noncancerous?
A number of noncancerous conditions can cause nipple discharge.
If your initial medical evaluation indicates the discharge is abnormal, your doctor may ask for more tests. The tests will help determine the underlying condition that's causing the problem and may include one or more of the following:
Laboratory analysis of the discharge
Mammogram and/or ultrasound of one or both breasts
A brain scan
Surgical excision and analysis of one or more ducts in your nipple
Possible causes of abnormal discharge include:
Fibrocystic breast changes. Fibrocystic refers to the presence or development of fibrous tissue and cysts. Fibrocystic changes in your breasts may cause lumps or thickenings in your breast tissue. They do not indicate, though, the presence of cancer. In addition to causing pain and itching, fibrocystic breast changes can, at times, cause secretion of clear, white, yellow, or green nipple discharge.
Galactorrhea. It might sound scary. But galactorrhea simply describes a condition in which a woman's breast secretes milk or a milky nipple discharge even though she is not breastfeeding. Galactorrhea is not a disease and has many possible causes. These include:
Pituitary gland tumors
Certain medications, including some hormones and psychotropic drugs
Infection. Nipple discharge that contains pus may indicate an infection in your breast. This is also known as mastitis. Mastitis is usually seen in women who are breastfeeding. But it can develop in women who are not lactating. If you have an infection or abscess in your breast, you may also notice that your breast is sore, red, or warm to the touch.
Mammary duct ectasia. This is the second most common cause of abnormal nipple discharge. It is typically seen in women who are approaching menopause. This condition results in inflammation and possible blockage of ducts located underneath the nipple. When this occurs, an infection may develop that results in thick, greenish nipple discharge.
Intraductal papilloma. These are noncancerous growths in the ducts of the breast. They are the most common reason women experience abnormal nipple discharge. When they become inflamed, intraductal papillomas may result in nipple discharge that contains blood or is sticky in texture.