Nipple secretion: Reasons and options for management
In the realm of health concerns, nipple discharge can be a worrying symptom for many individuals. While nipple discharge can occur naturally, especially during pregnancy or breastfeeding, non-physiological nipple discharge—also known as pathological nipple discharge—may indicate an underlying issue.
Non-physiological nipple discharge can stem from several breast-related conditions and systemic factors. In both males and females, the most common causes include intraductal papilloma, mammary duct ectasia, breast cancer, fibrocystic breast changes, breast abscess or infection, and hyperprolactinemia-induced galactorrhea.
1. Intraductal papilloma: This is the most common cause, accounting for up to 58% of pathological nipple discharge cases. Typically unilateral and involving discharge from a single duct, the discharge can be clear, bloody, or serosanguineous.
2. Mammary duct ectasia: This condition involves dilation and inflammation of the mammary ducts, often presenting with colored green or yellow nipple discharge.
3. Breast cancer: Nipple discharge can sometimes be a sign of underlying malignancy, especially if the discharge is unilateral, spontaneous, and bloody.
4. Fibrocystic breast changes: These benign changes in the breast tissue can lead to various types of nipple discharge but are generally associated with cyclical hormonal changes.
5. Breast abscess and inflammatory breast disease: Infection of breast tissue (mastitis) or abscess formation can cause nipple discharge, often purulent and accompanied by local inflammation and systemic symptoms.
6. Hyperprolactinemia-related galactorrhea: Non-physiological nipple discharge that is milky (galactorrhea) can be due to elevated prolactin levels caused by pituitary adenomas (prolactinomas), medications, hypothyroidism, chronic kidney disease, or cirrhosis.
It's essential to note that non-physiological nipple discharge is often unilateral, spontaneous, and non-milky, distinguishing it from physiological discharge which is typically bilateral and related to stimulation or hormonal states like pregnancy.
Anyone experiencing nipple discharge should consult a doctor for further evaluation. It's also important to avoid squeezing out nipple discharge as it can cause irritation or pain. Nipple discharge due to a physiological response does not usually require any treatment.
While breast cancer and papillomas are much rarer in males, nipple discharge in males can indicate an underlying issue such as breast cancer. Clear discharge from one breast can be a symptom of breast cancer. Spontaneous or one-sided nipple discharge can be atypical. If nipple discharge occurs suddenly or without manipulation, is persistent or bloody, comes out of one nipple, or occurs with other symptoms, a person should speak with a doctor.
[1] Mayo Clinic. (2021). Nipple discharge. [online] Available at: https://www.mayoclinic.org/diseases-conditions/breast-cancer/in-depth/nipple-discharge/art-20045952
[2] National Breast Cancer Foundation. (2021). Galactorrhea. [online] Available at: https://www.nationalbreastcancer.org/galactorrhea
[3] American Cancer Society. (2021). Nipple discharge. [online] Available at: https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/signs-and-symptoms/nipple-changes.html
- Intraductal papilloma, which is common in pathological nipple discharge cases, can cause discharge that is clear, bloody, or serosanguineous.
- Mammary duct ectasia might lead to colored green or yellow nipple discharge as a result of dilation and inflammation of the mammary ducts.
- Breast cancer can manifest through nipple discharge, especially if the discharge is unilateral, spontaneous, and bloody, potentially signaling an underlying malignancy.
- Fibrocystic breast changes, characterized by benign alterations in breast tissue, may result in various types of nipple discharge, mainly associated with cyclical hormonal changes.
- Breast abscess or inflammatory breast disease can cause nipple discharge, often purulent, accompanied by local inflammation, and systemic symptoms.
- Hyperprolactinemia-related galactorrhea, characterized by non-physiological nipple discharge that is milky in nature, can be attributed to several factors, including pituitary adenomas, medications, hypothyroidism, chronic kidney disease, or cirrhosis.
- To distinguish non-physiological nipple discharge from physiological discharge, it's essential to note that non-physiological discharge is usually unilateral, spontaneous, and non-milky.
- Anyone encountering nipple discharge is advised to consult a healthcare professional for further evaluation, and should avoid squeezing the nipple to prevent irritation or pain.
- Although breast cancer and papillomas are less common in males, they can still indicate an underlying issue if nipple discharge occurs in males, especially if the discharge is clear or from a single breast.
- Nipple discharge in males that is spontaneous, one-sided, persistent, bloody, or comes out of one nipple, accompanied by other symptoms, requires medical attention.
- Beyond breast-related conditions, chronic diseases, respiratory conditions, digestive health, eye health, hearing issues, mental health, men's health, skin conditions, sexual health, and nutrition are other significant aspects of health and wellness, including fitness and exercise, which are vital to maintaining overall health and wellbeing.
