My nipples are leaking fluid, should I be worried?
This is an important subject.
Let me share some information with you about this.
One of the very common complaints that I deal with as a breast surgeon is the issue of fluid
coming out of the nipple when you are not pregnant and you are not obviously breastfeeding
and the kind of fluid that can come out of the nipple include things like blood, includes
sort of a watery greenish fluid.
It can be a rust color fluid.
It can actually be milk and yet you are not pregnant and have not been recently breastfeeding.
It can be almost toothpaste like sticky material that can come out of the nipple and the people
are constantly concern do I have breast cancers, is this finding for breast cancer and the
answer is that the typical or usual breast cancer is not, I repeat not associated with
the nipple discharge.
This is particularly true for a bloody nipple discharge.
In fact, the vast-vast majority of bloody nipple discharges are from a benign disorder
called an intra meaning inside, ductal inside the duct papilloma fancy word for overgrowth
of the tissue that lines the ducts and they get rough you well and they can discharge
blood.
Now because cancers can in fact do this, we always work these patients up completely and
the workup would include mammograms, would include an ultrasound examination and sometimes,
but not very common at all would include a breast MRI exam.
Family history is important that we take that in when we talk about women with nipple discharges
as well.
The vast majority of nipple discharges that I have seen throughout my career are actually
women in their 40s and it's associated with fibrocystic changes of the breast, cysts form
in the breast, ducts dilate up, there is an entity called ductal ectasia big fancy word
for an unknown reason that ducts can dilate up, it can be associated with a nipple discharge.
The sticky discharge that I was talking about a minute ago can often come from this unusual
entity called duct ectasia, so if you do have a nipple discharge, you do need to be evaluated.
You need to see your physician, at a minimum you need an ultrasound examination, but it
frankly should be coupled with a mammogram particularly if you haven't had one.
Now, if we see an abnormality in the ductal system then what is typically done is what's
called the ductogram, a very-very fine catheter is threaded down inside the duct that we see
having the fluid come out of it, we then gently inject a contrast material so that we can
see what's going on inside the duct and often that scheduled on the same day that surgery
is scheduled, so if we see something, we can go immediately to the operating room and take
it out.
Once again, vast majority of nipple discharges are not breast cancer.
However, they do need to be evaluated, make sure that you see competent, educated physicians,
and people dealing with breast disease to have such an evaluation.