Nipple discharge

The mammary gland is an organ that initially assumes the natural secretion of colostrum and milk. However, sometimes nipple discharge is not related to lactation, but means the development of some disease.

Are such discharges always a sign of pathology, and when should you sound the alarm?

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Causes nipple discharge

Physiological (normal) discharge from the nipples is known to everyone - this is lactation, that is, the release of breast milk in pregnant and lactating women. However, sometimes this phenomenon can mean the development of some pathology.

• Duct ectasia is a widening of the subalveolar ducts, which is most often associated with age-related changes in the glands. The discharge with ectasia is thick, greenish-yellow or brown.
• Papilloma is a benign tumor inside the duct, which causes small bloody discharge.
• Galactorrhea is the secretion of milky fluid from the nipple, which is not associated with pregnancy and childbirth. As a rule, this condition is explained by increased production of prolactin, a special hormone that stimulates milk secretion. In turn, galactorrhea can be caused by treatment with contraceptives, hormonal imbalance, hypothyroidism, and pituitary dysfunction.
• Trauma to the breast can also cause bleeding from the nipple.
• Inflammatory processes in the mammary gland with signs of suppuration can cause the discharge of pus from the nipple.
• Changes in hormonal levels and, as a consequence, mastopathy are a common cause of discharge.
• Oncological diseases of the glands are intraductal carcinoma or invasive tumor. One of the signs of malignant pathology is the release of a liquid substance from the nipple.

Pathogenesis

The mammary glands are paired organs that perform the function of glands - that is, their purpose is to secrete a secretion. But not every and not always. Everyone knows that the breast is the source of milk during lactation in women. Each gland consists of lobes and lobules, divided by specific partitions. Each lobe is connected to the nipple by a milk canal through which milk flows.

During the period of bearing a baby, the glandular tissues swell, which means the moment of readiness for the process of breastfeeding.

In addition to lactation, discharge can be considered normal in the following cases:

• immediately before the start of the monthly cycle and menstrual bleeding;
• during sexual arousal, breast stimulation and orgasm.

In an excited state, a person produces the hormone oxytocin, which causes the milk ducts to contract. As a result, several drops of clear (!) liquid may be released. If the color of the liquid is red, black or green, this should alert the woman: perhaps the integrity of the tissue or duct is damaged, which contributes to blood or pus entering the duct and exiting.

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Symptoms nipple discharge

There may be discharge from the nipples when pressing on the areola, but more often the secretion flows out on its own.

The consistency of the separated substance can be liquid or viscous.

The color can also vary from clear, translucent, yellowish-greenish and milky discharge to bloody, brown and even black.

Most often, secretion appears in patients after 50 years of age, and at a young age - much less often. The risk of developing breast pathologies increases with age, as well as with the number of pregnancies, abortions, and periods of breastfeeding.

When discharge appears, it is necessary to especially carefully determine the quantity, color and smell of the secretion that has appeared. These signs may indicate the development of a certain pathology that needs to be treated without waiting for negative consequences to occur.

• White discharge from the nipples normally appears during the lactation period and is breast milk. In other situations, it may be a sign of galactorrhea - excessive production of the hormone prolactin, which ensures milk production.
• Yellow discharge from the nipples is also observed with galactorrhea, especially if the pathology is caused by insufficient liver or kidney function, thyroid disease, pituitary gland dysfunction, or long-term use of hormonal drugs.
• Brown discharge from the nipple may occur after a recent chest injury or other damage to the milk ducts or vessels. Such damage is usually caused by tumors, such as cysts - in this case, the secretion is often brown with a greenish or grayish tint.
• Bloody discharge from the juice often indicates the presence of serious diseases, often malignant. However, in some cases, blood from the nipple is released with intraductal papilloma, which, however, can also degenerate into an oncological disease over time.
• Green discharge from the nipple indicates that the secretion contains a greater or lesser amount of pus. In this case, the secreted liquid may have a grayish or yellowish tint. This condition is characteristic of mastopathy - a dyshormonal disorder characterized by the appearance of seals and pain in the glands.
• Transparent discharge from the nipples can be caused by physiological reasons - stress, menstrual cycle, stimulation. Normally, such transparent discharge is insignificant (just a few drops) and is not accompanied by odor or discomfort.
• Purulent discharge from the nipple is a common problem in the development of inflammatory diseases of the mammary gland. For example, purulent abscess formation can occur during breastfeeding, when an infection gets into the milk ducts. This disease is often accompanied by soreness of the gland, redness of the areola and increasing swelling.
• Sticky discharge from the nipple, with a variety of colors, is a typical symptom of deformation of the subalveolar ducts or their blockage. An additional sign of this condition may be tissue compaction around the nipple, as well as an inverted nipple.
• Gray discharge from the nipple is sometimes caused by increased levels of prolactin in the body. This symptom can be observed during pregnancy or with long-term use of contraceptives and other hormonal drugs.
• Smelly discharge from the nipples usually accompanies inflammatory diseases of the mammary glands, namely the purulent stage of the process. The fact is that bacteria and their waste products can emit a specific odor, which is especially pronounced with purulent discharge. Inflammatory diseases always occur with significant painful sensations, redness and swelling of the glands. Temperature indicators may increase - both local and general body temperature.
• Black discharge from the nipples in the vast majority of cases indicates the presence of blood in the secretion, which is typical of many tumor processes. In this case, the blood is black due to the fact that the pathological focus is most likely located deep in the gland tissue, and not directly near the surface.
• Dry discharge from the nipples is a common sign of mammary gland ectasia. Dry or thick secretion is formed from thick and viscous secretions that accumulate in the lumen of the milk duct. Such secretion can have different colors and smells.
• Curdy discharge from the nipples is a rare occurrence, but sometimes it happens if a fungal infection gets into the milk ducts during breastfeeding. Women who have cracks and sores on their nipples are especially susceptible to the disease. The curdy secretion may have a sour smell. The breasts hurt and itch, and the volume of milk secreted may decrease.

Each disease of the mammary glands is defined by its symptoms. It is almost impossible to recognize the disease on your own, so seeking medical help should be immediate.

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Nipple discharge before menstruation

If nipple discharge appears before or during menstruation, then such a sign may indicate a strong change in hormonal levels. We are talking primarily about the hormone prolactin, which is responsible for lactation. Changes in hormonal levels can be disrupted for several reasons, but most often this occurs as a result of prolonged use of contraceptives.

Discharge before menstruation is usually insignificant, and the secretion looks like colostrum: it can be transparent, light, yellowish. In order to determine the cause of this phenomenon, it is recommended to take a blood test for prolactin content.

Sometimes it happens that a woman continues to secrete a small amount of milk before her period for several years after giving birth. The reason for this may be the same prolactin, the level of which decreases more slowly than in other women.

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Nipple discharge during pregnancy

Secretion from the mammary glands can begin not only immediately after childbirth, but also during pregnancy. Of course, this does not happen to everyone, but it is quite common.

Nipple discharge during pregnancy has a slightly yellowish or light tint - this is nothing more than colostrum, which is a liquid that precedes breast milk. Why is it released?

A pregnant woman's mammary glands rapidly increase in size throughout the entire period of gestation: glandular tissue structures grow, and this growth is stimulated by the hormone prolactin.

Nipple discharge before childbirth occurs most often. In some women, colostrum begins to be produced only on the third day after childbirth. However, in some cases, with active production of prolactin, milk can appear much earlier, from about the 20th week of pregnancy. Very rarely, a small amount of colostrum can be noticed in the first trimester - this is also considered one of the normal options.

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Complications and consequences

The extent of the consequences of pathological discharge from the nipples depends on what disease causes them.

If the secretion is not related to physiological reasons (lactation period, pregnancy, nipple stimulation), then it is necessary to consult a mammologist or gynecologist. If you do not do this in time, you can expose yourself to the risk of serious diseases:

• telitis – an inflammatory process in the nipple (often the infection enters through cracks in the nipple area);
• mastitis is an inflammatory process in the tissues of the mammary gland (can develop due to milk stagnation during breastfeeding, or for other reasons);
• malignant tumors of the mammary gland;
• Diffuse and nodular mastopathy is a proliferative process in the mammary gland.

To avoid the development of the above-mentioned diseases, it is very important to visit a doctor in a timely manner for a preventive examination. You should be especially wary if you detect any discharge from the nipples that appeared for an unknown reason.

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Diagnostics nipple discharge

During a consultation regarding nipple discharge, the doctor may prescribe certain types of examinations, including tests. The diagnostic methods used depend on the disease suspected.

• The medical examination includes a visual assessment and palpation of the mammary glands.
• The X-ray method, or mammography, involves examining patients over 50. The doctor receives an image from two angles, which allows for a detailed examination of the structure of the mammary glands.

• The ultrasound method can be used to examine patients of any age. The ultrasound procedure visualizes both the gland tissue and the nearest lymph nodes.
• Ductography is used to examine milk ducts;
• Cytological analysis is based on the study of material taken from the gland tissue. Such a study is most often carried out when a tumor process is suspected.
• Immunohistochemical analysis allows us to identify the nature of the neoplasm, if one has been detected.

Additionally, instrumental diagnostics may be prescribed in the form of methods such as computed tomography, chest X-ray, radioisotope visualization of the skeletal system, and ultrasound examination of the liver (to search for possible metastases).

Among the tests, they often suggest taking a blood test for hormone levels, a general blood test for the presence of an inflammatory process, and also conducting a study for tumor markers (this test determines the likelihood of a cancerous tumor).

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Differential diagnosis

Differential diagnosis is usually made between the following diseases:

• nodular mastopathy;
• fibroadenoma;
• lymphogranuloma;
• mastitis;
• intraductal papilloma;
• malignant tumor;
• galactocele.

Treatment nipple discharge

Spontaneous secretion from the nipples cannot be cured without knowing the true cause of its appearance. For this purpose, diagnostics are carried out, the purpose of which is to determine the factor causing discharge from the mammary glands.

Therefore, the question of what to do if there is discharge from the nipples can be answered unequivocally: consult a doctor and undergo a thorough diagnosis.

It may be necessary to adjust the hormonal background. There are special drugs for this - DA agonists, which include Bromocriptine and Parlodel. These drugs inhibit the synthesis of prolactin. The standard dosage of drugs is from 2.5 to 3.75 mg per day. At the discretion of the doctor, the amount of the drug can be increased by 2 times. The duration of the course of treatment is until the hormonal level stabilizes.

Folk treatment of nipple discharge can be carried out only after consultation with a doctor, after passing all the necessary tests and making a final diagnosis.

You can't treat a symptom without knowing the cause of the pathology. Therefore, do not rush to start herbal treatment - first find out what disease caused the discharge.

The same can be said about such a method of treatment as homeopathy. Any therapy begins only after the diagnosis is known. If the patient begins to treat the inflammatory process on her own, but in fact it turns out that she has a malignant tumor, the consequences can be unpredictable. Often in such cases, surgical treatment has to be prescribed.

You should not rush to unconventional methods of treating nipple discharge. Without knowing the cause of the discharge, you can significantly harm your health.

Prevention

Prevention of nipple discharge consists of following recommendations for maintaining the health of the mammary glands. These recommendations are quite simple, but very important for the normal functioning of the body.

• It is necessary to avoid stressful situations, nervous shocks, psycho-emotional stress in every possible way. Stress has an extremely negative effect on hormonal levels, which contributes to the development of breast diseases.
• It is recommended to maintain a healthy lifestyle: do not smoke, do not abuse alcoholic beverages, go to bed on time, eat well, be physically active. A healthy lifestyle helps keep your immune system strong.
• It is important to monitor your weight. The fact is that extra pounds can lead to unwanted changes in the mammary glands, which over the years can develop into a disease with the appearance of discharge from the nipples.
• Contraceptive use should be short-term. You cannot select contraceptive drugs on your own - this choice must be agreed upon with your doctor.
• Self-examination of the breasts should be carried out monthly - this is a necessary stage of prevention and early detection of dangerous diseases.
• All women are recommended to undergo examination by a mammologist every two years, and after 50 years – annually.

You cannot ignore suspicious symptoms; you need to seek help from a specialist in a timely manner.

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Forecast

The prognosis of such a symptom as nipple discharge directly depends on the underlying disease: the more complex and dangerous the diagnosis, the worse the prognosis. Physiological discharge is considered normal and disappears on its own over time.

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