• Clinical science

Nipple discharge

Abstract

Nipple discharge in non-lactating women can be classified as either galactorrhea or non-milky nipple discharge. Galactorrhea is usually caused by hyperprolactinemia and is associated with endocrine disorders or medication. Most of the causes of non-milky nipple discharge are benign, with less than 15% of cases related to cancer. The diagnostic approach is based on patient history and the characteristics of the discharge. Spontaneous, unilateral, and/or bloody nipple discharge, especially in women older than 40 years, should raise suspicion of malignancy. Treatment depends on the underlying disorder.

Definition

  • Lactation: normal milk production in breastfeeding women
  • Galactorrhea: milk production in non-breastfeeding women or men
  • Non-milky nipple discharge: production and secretion of fluids other than milk

References:[1][2]

Etiology

References:[3]

Diagnostics

Signs that suggest malignancy

  • Spontaneous, unilateral; , uniductal, and bloody, or guaiac-positive discharge
  • Presence of a breast mass or abnormalities in imaging
  • Age > 40 years

Biopsy is mandatory if malignant disease is suspected.
References:[3][4]

Treatment

References:[3]