Nipple discharge in women: Secretions often more alarming than dangerous

Most women who've breast-fed have experienced unwelcome moments of nipple discharge. But having a discharge unrelated to breast-feeding is understandably concerning.

Because your breast is a gland, secretions from your nipples aren't unusual, even for women who've never been pregnant.

Fortunately, nipple discharge usually isn't associated with cancer (malignancy). Several conditions could be responsible for the secretions. In some cases, nipple discharge does require treatment and may not go away on its own. Discover what might cause nipple discharge, and how your doctor will find and treat the underlying cause.

What is nipple discharge?

Any fluids that seep out of your nipple are referred to as nipple discharge. Your nipples have many tiny openings through which fluid can pass. In the case of the nursing mother, this fluid is breast milk. In other cases, it may look like milk but it really isn't. The fluid can differ with regard to color — from milky white to yellow, green, brown or bloody — and consistency — from thin and watery to thick and sticky.

Nipple discharge can happen in one or both nipples. It can be spontaneous — happening on its own at any time — or happen only when you squeeze your nipple or manipulate your breast in some way. Your chances of having unusual nipple discharge increase as you get older and with the number of pregnancies you've had.

If you have unusual nipple discharge, make an appointment with your doctor to have it evaluated. A visit to your doctor is especially important if you also notice breast changes, such as a new lump or skin changes. This will help your doctor identify the root of the problem.

Make an appointment with your doctor

Your doctor will likely ask you some questions to gain a better understanding of what's going on. Specifically, he or she may want to know:

• What color is the discharge?
• How much discharge is there?
• Does it happen in one or both breasts?
• Does the discharge appear to come from one opening in your nipple or multiple openings?
• Is the discharge spontaneous, or does it happen only when you squeeze your nipple?
• Do you have any other signs and symptoms, such as fever, redness, pain in the breast, headaches or vision changes?
• Have you recently experienced an injury to the chest?
• What medications do you take?

Be prepared to answer these types of questions and bring up any other observations you think may be relevant. For instance, your doctor might want to know how long you've experienced the nipple discharge and certain facts about your medical history.

Based on the information you provide and the results of a physical exam, you might need to undergo additional testing to help pinpoint the underlying cause. Such testing might include a blood test, mammography, a breast ultrasound, a special type of X-ray (ductogram) or magnetic resonance imaging (MRI). Your doctor might collect a sample of the fluid to send to a lab for analysis. However, even after lab analysis, further evaluation may be necessary.

Determine possible causes

Your nipple discharge might just be a normal (physiological) part of your breast's function. That is, it might not be caused by any underlying disease. On the other hand, if your doctor determines that your nipple changes aren't normal breast gland secretions, other causes may be considered.

Among the many possible causes of nipple discharge are:

Normal functioning (physiological discharge)
Physiological nipple discharge usually occurs in both breasts and happens only when the breast tissue is manipulated in some way, such as by squeezing the nipple to check for discharge. The discharge may be clear, yellow, white or dark green. Stimulation of the nipple actually increases the likelihood of discharge, so it's best to leave your nipples alone and avoid checking them. This type of discharge often resolves on its own.

An inflamed duct (mammary duct ectasia)
Mammary duct ectasia is one of the most common conditions related to abnormal nipple discharge. It causes one or more of the ducts beneath your nipple to become inflamed and clogged with a thick, sticky substance that's green or black. Most often, it affects women in their 40s and 50s. You can relieve some of your symptoms by applying warm compresses to your breast. Taking aspirin or nonsteroidal anti-inflammatory drugs, such as ibuprofen, may help relieve some symptoms. Also, your doctor may prescribe antibiotics to clear up any infection. In some cases, surgery might be necessary to remove the affected duct.

Gain peace of mind

Take comfort in knowing that most nipple problems are the result of a benign condition. They're usually more scary than dangerous. But it's best to see your doctor anytime you notice changes in your nipples or breasts because the problem may require treatment. By determining the underlying cause, your doctor can remedy your problem. And if you learn that the nipple discharge results from a more serious condition, catching the problem early gives you the best chance for recovery.