It is normal for a lactating mother to have fluid seeping from her breasts. But for those who aren’t lactating, a nipple discharge can be quite distressing. To start with, it is very important to bear in mind that such a discharge is mostly non-cancerous. This is the third most common complaint in women after breast pain and breast mass (lumps).
What is Nipple Discharge?
Abnormal release of fluids other than milk from breasts of non-lactating women is termed as nipple discharge.
Why Does It Occur?
In non-lactating women, small tissues form plugs that prevent seeping of any fluid from the nipple. But sometimes, non-nursing women discharge a milky fluid from their nipples, a condition termed ‘galactorrhea’. Hormones prolactin and oxytocin are known to stimulate milk production in women right after birth. Therefore any drug that stimulates prolactin production might lead to galactorrhea in non-lactating women.
In some women with pituitary tumours, excess production of prolactin is observed which is another cause of galactorrhea.
In premenopausal women, extreme fluctuations in hormonal levels lead to nipple discharge.
Infections or a benign condition such as papilloma is another cause for nipple discharge. A papilloma, also called intraductal papilloma is a non-cancerous growth within the milk duct, usually near the nipple. 90% of women complaining of nipple discharge have papillomas.
Another condition termed duct ectasia is also known to cause nipple discharge. This condition is caused due to either an inflammation, dilatation or hardening of milk ducts due to age, fluctuating hormone levels, smoking or in those who have inverted nipples.
Any kind of mechanical stimulation, irritation or excessive squeezing is also known to cause discharge.
When is Nipple Discharge Serious?
In 90% of cases, a watery nipple discharge stems from a benign condition and therefore not cancerous. However, nipple discharge is a concern if it:
- Is sticky and clear in colour or brown to black in colour (opalescent)
- Appears spontaneously without squeezing the nipple
- Is persistent
- Is unilateral (one breast only)
- Is fluid other than breast milk
Where to Go Next and What is the Further Course of Action?
Any kind of nipple discharge must be brought to the attention of a healthcare provider. Fortunately, a nipple discharge rarely means cancer. Nevertheless, further examination must be done to rule it out completely. If discharge happens freely from both breasts and has milky appearance, tests to evaluate prolactin levels must be done. A high level of this hormone indicates presence of a benign pituitary tumour, prolactinoma. These are rare tumours and appropriate treatment action would be suggested.
Thyroid imbalance also affects breasts, therefore a simple blood test to check thyroid levels may also be recommended.
