Types of nipple discharge- Causes and symptoms

Nipple discharge is quite a common sight during reproduction years. Nipple discharge can cause a fluid or any other liquid to come out of your nipples. The fluid may come out of your nipples when you squeeze them, or it may even seep out on its own. In most cases, nipple discharges are not a serious cause of concern, but in some cases, they may even result in breast cancer. 

Thus, it is imperative to keep a check on any such nipple discharge and seek medical assistance to ensure that you are not facing any serious medical condition. Here in this guide, you will get to know the different types of nipple discharge and other nipple discharge guidelines: 

Types of discharge

To understand the different types of discharge, the doctor may ask you various questions about the discharge color and its type. Here are a few common nipple discharges:

Clear discharge

A clear discharge from both breasts is usually not a cause of concern, but it comes out of just one breast can be a sign of breast cancer. 

Bloody discharge

A blood discharge from the nipples can be caused due to papilloma, which is a type of non-cancerous tumor. It can cause breast irritation, and in rare cases, bloody discharge may also occur due to breast cancer. 

Milky discharge

It is a common nipple discharge problem faced by women and usually occurs when a woman has stopped breastfeeding their baby recently. Milky discharge is also quite common when a woman is about to reach menopause which causes hormonal shifts.

Green nipple discharge

A green-coloured nipple discharge may result due to the presence of a cyst beneath the areola or nipple. 

Here is a quick sum of the colour and cause of nipple discharge

• Clear- breast cancer, blocked milk ducts
• Yellow: infection
• Brown: Fibrocystic breast condition
• Red: Breast cancer, intraductal papilloma
• Milky white: hormone changes, galactorrhoea, breastfeeding
• Green: Fibrocystic breasts, blocked milk ducts

Common causes of nipple discharge

When a woman is pregnant or is a lactating mother, breast milk is prone to leak causing a nipple discharge. But breast discharge may also occur due to other reasons. Here are a few common nipple discharge causes:

Fibrocystic breasts

If you have lumpy or painful breast tissues, it is possibly a sign of fibrocystic breasts or you are about to enter the premenopausal stage. Also, you can happen to find yellow, green, or brown colour discharge before getting your period. 

Hormonal Medications

Taking hormonal medicines such as sedatives and birth control pills can also cause milk discharge from the nipples. 

Pregnancy

In the case of pregnancy, many women are prone to witness a light-yellow colour and thin pre-breast milk discharge from their nipples. It can further turn down into thick and milky discharge.

Hormonal changes

Normal hormonal variations, such as the change in prolactin levels, and menstruation, can also cause nipple discharge. 

Breast irritation

Wearing ill-fitted clothes or tight-fitted clothes quite often can also cause nipple discharge. Such clothes or conditions that cause trauma or excess stimulation to the breasts can result in nipple discharge. 

Breast infection

Nipple discharge may also result due to breast infection, which can result in a yellow-green colour pus-like discharge. It may further also cause fever, breast tenderness, and pain. If the nipple discharge also gives out a foul smell, then there are chances that the person may have an abscess in their nipples.

Mammary Duct Ectasia

Mammary duct ectasia is a medical condition that usually occurs during menopause or perimenopause, which causes blocked milk ducts. Due to this, the ducts of the breast widen and get clogged with a thick discharge. The discharge can be green, black, or brown in colour. Usually, such discharge is thick, accompanied by red and tender nipples.

Such a condition may also result in mastitis, causing nipple inversion and raising breast cancer concerns. Mammary duct ectasia generally goes away with time, but in some cases, it may even require surgery. 

Paget’s disease

Though rare and uncommon, it is a type of breast cancer that causes a bloody discharge. This condition can also cause scaling, redness, flaking, burning, and nipple tenderness. To diagnose Paget’s disease, a biopsy is usually suggested. 

Breast cancer

In some cases, a nipple discharge may be an early warning symptom of breast cancer. In such a condition, the nipple discharge is spontaneous and occurs only from one of the breasts. Such discharges can be clear, milky, or bloody.

Galactorrhoea

Galactorrhoea occurs due to an increased prolactin level. Prolactin is a hormone that is associated with the growth of breasts and breastfeeding, which is known as hyperprolactinemia. The increased level of prolactin can happen due to medications, hypothyroidism, herbal supplements, and even pituitary microadenomas.

Diagnosis of Nipple discharge

There are different types of tests that can help in diagnosing nipple discharge. The diagnosis test may vary based on the age, physical examination, and nipple discharge symptoms of a patient. Here are a few diagnostic tests that your doctor may prescribe you: 

• Cytology: In this method of diagnosis, the nipple discharge sample is checked for cancerous cells. 
• Blood test: Blood tests are prescribed to check the thyroid-stimulating hormones and prolactin levels. 
• Biopsy: Biopsy of the breasts is prescribed to find out any lumps near the nipples. 
• Ultrasound: An ultrasound is suggested to examine any abnormality in the areola and nipples. It helps in identifying papilloma, and a biopsy procedure may also be required in such a case. 
• Ductogram: In this method, a dye is injected to examine breast milk.
• Brain MRI and CT scan: CT scan (computed tomography) and MRI (Magnetic resonance imaging) is done to check pituitary microadenoma.