Symptoms and Treatment of Nipple Discharge

Symptoms and Diagnosis

[ Symptoms ] Nipple discharge can occur from both nipples, or it may occur from only one nipple. It most often occurs when the nipple is stimulated or the breast is compressed, but it can also occur without nipple stimulation. The color of nipple discharge can vary: it may be clear like water, yellow, red mixed with blood, green, or dark blue. Its consistency can also vary, being thick, thin, clear, or cloudy. Therefore, it is difficult to determine the exact cause based only on the characteristics and appearance of the nipple discharge. Nipple discharge is usually caused by physiological factors or benign diseases, but breast cancer must always be ruled out. Therefore, if any of the following symptoms occur, medical evaluation is necessary:

• A lump is felt at the same time.
• The nipple discharge comes from only one breast.
• The nipple discharge is bloody red.
• Nipple discharge occurs even without nipple stimulation.

[ Diagnosis ] It is important to first distinguish whether the cause of nipple discharge is physiological or pathological. A medical history that includes pregnancy and childbirth history, as well as medications or health supplements currently being taken, is important. It is also necessary to check whether the discharge is from both breasts or one, whether it is blood-tinged red, whether a lump is felt at the same time, whether there are abnormal skin lesions on the breast, and whether there is accompanying lymph node enlargement. To rule out systemic disease, blood tests including hormone level tests, mammography, and breast ultrasound are performed. If a mass is found in the breast through mammography and breast ultrasound, a tissue biopsy may be performed if necessary. Depending on the doctor's judgment, the nipple discharge may also be collected and examined for signs of inflammation or cancer cells.

Treatment

Treatment for nipple discharge depends on the underlying cause. If nipple discharge occurs due to hormonal changes or nipple stimulation, treatment is not necessary. If nipple discharge occurs due to breast stimulation or pressure, avoid wearing a tight bra or clothing that fits closely to the body. If nipple discharge occurs due to medication, stop the herbal tea or health food that is causing it, and if the causative medication is a therapeutic drug, consult the attending physician about changing the medication; if the medication does not need to be taken continuously, discontinue it. As a drug treatment for nipple discharge, bromocriptine, a medication that suppresses the production of lactation hormone (prolactin), can be used.

If excessive production of lactation hormone occurs due to a pituitary tumor, surgery to remove the tumor is necessary. Mastitis caused by a duct infection is treated with antibiotics, and if recurrences are frequent, surgery to remove the infected duct is necessary. Bloody discharge caused by benign tumors within the breast, such as intraductal papilloma, is treated with duct excision surgery.

So far, we have covered the symptoms and treatment of nipple discharge. In the next part, we will look at male breast cancer.

Source: Korea Disease Control and Prevention Agency, National Health Information Portal