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Nipple discharge - abnormal - Overview

Alternative Names

Discharge from breasts; Milk secretions; Lactation - abnormal; Witches milk; Galactorrhea

Definition of Nipple discharge - abnormal:

Abnormal nipple discharge is abnormal fluid leakage from one or both nipples of the breast.

Considerations:

The likelihood of nipple discharge increases with age and number of pregnancies.

While a milky nipple discharge is rare in men and in women who have never been pregnant, it does occur. When it does, it is likely to be caused by some underlying disease, particularly when accompanied by other changes in the breast(s).

It is relatively common in women who have had at least one pregnancy. A thin yellowish or milky discharge (colostrum) is normal in the final weeks of pregnancy.

The nature of the discharge can range in color, consistency, composition, and may occur on one side or both sides.

"Witch's milk" is a term used to describe nipple discharge in a newborn. The discharge is a temporary response to the increased levels of maternal hormones. Witch's milk should disappear within 2 weeks as hormone levels dissipate in the newborn.

Other nipple discharges can be bloody or purulent (containing pus), depending on the cause.

Common Causes:

  • A tumor in the brain called a prolactinoma
  • A small noncancerous growth in the breast called an intraductal papilloma
  • Breast abscess (most commonly seen in women during breastfeeding)
  • Breast cancer
  • Fibrocystic changes in the breast
  • Injury to the breast(s)
  • Use of certain drugs including birth control pills, cimetidine, methyldopa, metoclopramide, phenothiazines, reserpine, tricyclic antidepressants, or verapamil
  • Widening of the milk ducts called ductal ectasia
  • Reviewed last on: 5/26/2008
  • Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Galactorrhea. In: Ferri FF. Ferri’s Clinical Advisor 2008: Instant Diagnosis and Treatment. 1st ed. St. Louis, Mo: Mosby; 2008.

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