Nipple Discharge: Causes And Indications
Nipple discharge can be a very annoying problem, but in all cases there are underlying causes that motivate it. These range from breast dysplasia to, in very rare cases, cancer.
We talk about galactorrhea when milky secretions are present even if you are not breastfeeding. It often has hormonal causes and can also occur in men. Would you like to know more? Read on!
Nipple discharge: are there any other symptoms?
The most common symptom is fluid leaking from the nipple or small holes in the areola. The appearance of these secretions varies:
- Whitish or milky.
- Serous, pale or slightly yellowish.
- Reddish.
- Combinations of the above.
Depending on the cause, the woman experiences permanent pain or only when the liquid is leaking. It is also possible to detect a mass or lump with different characteristics (size, position, mobility and consistency).
In most cases, the discharge is unilateral (ie it affects only one breast), although it can be bilateral in the presence of hormonal disorders.
In addition to this, nipple retraction or skin redness suggesting inflammation may also occur.
Reasons there may be nipple discharge
There is a huge list of causes that can produce these types of symptoms. For practical reasons, they can be summarized in causes of breast origin (such as infections or cancer) or extramammary (brain tumors or drug intake).
Most frequent causes
We will examine the case of localized breast infections, the use of psychotropic drugs, intraductal papilloma and fibrocystic changes in the breast.
1. Localized breast infections
Mastitis or breast abscesses are common causes of secretions. Of course, the discharge is purulent and smells bad, as well as pain on palpation, an increase in volume and redness of the skin.
However, it is much more common during breastfeeding (due to the manipulation of the nipple by the baby), but it can also occur outside this period.
2. Taking psychotropic drugs
Prolactin is a hormone that stimulates the production and secretion of breast milk. It is regulated in the brain by a neurotransmitter known as dopamine.
Treatment with some drugs that act directly on the central nervous system can lead to changes in dopamine levels in the body. Consequently, this also affects the production of prolactin and breast milk.
Drugs that can cause milk to be released outside of the lactation period include phenothiazines, some antidepressants, and anxiolytic drugs.
3. Intraductal papilloma
Intraductal papilloma is a common benign condition, although its features usually attract a lot of attention. Indeed, several complementary studies are needed in his presence.
Discharge is usually spontaneous and often occurs in premenopausal patients. As in the previous example, the pathology originates in the milk duct.
There is a proliferation of cells which eventually leads to the formation of a small mass capable of producing serous secretion with some blood (serum blood).
4. Fibrocystic changes in the breast
Also known as “breast dysplasia”, according to various epidemiological studies, it is one of the most frequent benign breast diseases. It consists of the proliferation of “support tissue” (connective tissue) which can also occur during a woman’s reproductive life.
This leads to the formation of masses of moderate size, which can be painful, and which cause whitish secretions through multiple orifices.
In general, it affects both breasts and represents one of the most frequent reasons for consultation in gynecology.
Depending on the patient’s age, the doctor will request studies such as mammography to determine the likelihood of a malignant lesion. However, this happens on rare occasions.
Less frequent causes of nipple discharge
This group includes certain conditions such as galactophoritis, pituitary tumors, ductal ectasia, and breast cancer.
1. Galactophoritis
The sinuses contain structures called milk ducts, which can sometimes become inflamed. These are responsible for the passage to the outside of the substances produced by the mammary glands.
Often it is a chronic inflammation (ie it has a very long course), moreover a well-defined cause is not identified. Therefore, it can be both infectious and non-infectious.
2. Pituitary tumors
The most prominent example is prolactinoma, one of the most common causes of nipple discharge due to a neoplasm. Furthermore, the origin is extramammary, since it is located in the pituitary gland and has the ability to produce prolactin.
As we have already said, this hormone has the task of stimulating the production of breast milk. Specialized studies such as brain MRI are needed to diagnose this condition.
3. Ductal ectasia
The term “ectasia” refers to the dilation or opening, in this case, of the ducts closest to the nipple. Usually, it produces a secretion with a variety of colors ranging from yellow to brown.
It can affect both breasts and is a benign condition, as there is so far no evidence to suggest malignancy if left untreated. However, evaluation by a doctor is always necessary.
4. Breast cancer
We believe this is one of the less frequent causes. In fact, only in rare cases in the presence of a malignant origin does a nipple discharge occur.
Breast cancer usually occurs silently, which is why it is usually detected in late stages. For this reason, it is important to undergo periodic preventive visits.
When the cause is a neoplasm, there may be a retraction of the nipple and the presence of a nearby hard mass that is not always painful. Your doctor will indicate the corresponding tests for your diagnosis, such as mammography.
When to see a doctor?
We recommend that, in the presence of any of the above symptoms, you decide as soon as possible to contact a gynecologist or family doctor.
In most cases, this type of problem has a benign origin and in some cases does not require treatment. However, if there is a possibility that the discharge is the result of malignant disease, a medical evaluation is recommended.
Treatments for nipple discharge
Treatment essentially depends on the cause of the discharge and may not require therapeutic measures in some cases unless it represents significant discomfort to the person.
For cases where there is growth of tumor tissue (papillomas, prolactinomas and cancer), treatment may include the surgical solution with the removal of the affected mass.
If it is a condition developed from medication, it is advisable to vary the dose or modify the treatment. Finally, infectious diseases may require surgical drainage (such as abscesses) and the administration of antibiotics for a few days.
Seeing your doctor helps prevent unpleasant complications
Nipple discharge is a common problem and its causes are very diverse, as are the treatment options. However, any type of symptom should always be evaluated by a doctor.
Although not all visits need to be immediate or urgent, it is preferable to make an appointment well in advance to avoid unnecessary delays. Remember, sometimes the small symptoms can mask serious conditions.
