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Normally, if the ducts are stripped toward the nipple, a drop or two of
clear, milky, or greenish-tinged liquid will appear. This is not considered
nipple discharge.This image demonstrates milk from a lactating woman. This is also
considered normal.
If the nipples spontaneously leak discharge, staining the clothing,
that is not normal, nor is it normal to have bloody nipple secretions.
Nipple discharge from both breasts indicates "galactorrhea." While a few
post partum women will continue to leak small amounts of milk for years
following delivery, galactorrhea in general indicates the need for a
serum prolactin measurement and possibly an MRI of the pituitary gland to look for
prolactin-secreting pituitary adenomas. Hypothyroidism can also cause this
problem, although it is rare.
Athletes may experience small amounts of galactorrhea from constant rubbing
of the nipples against clothing. Frequent sexual stimulation of the breasts
may have similar effects. The serum prolactin
measurement is best made after a few days of non-stimulation of the breast.
Even after a breast exam, it is often helpful to wait 2 days before measuring
the serum prolactin.
Persistent discharge from a single duct, particularly if bloody,
rust-colored or multicolored, suggests the presence of an intraductal lesion,
such as an intraductal papilloma. While these are often benign, they need further
exploration with a general or breast surgeon.
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Nipple Discharge (In this case, lactation)
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5-Minute Clinical Breast Exam Video
Using the Vertical Strip
Method favored by many physicians. This image shows the Peau d'Orange skin
changes sometimes associated with malignancy.
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