Nipple Discharge

What is nipple discharge?

Nipple discharge is when fluid leaks from your nipple in one or both breasts. It’s most common in women in late pregnancy and immediately after childbirth. Nipple discharge happens for many reasons. Most of the time, there are normal, harmless reasons why women have nipple discharge even when they aren’t pregnant or lactating. However, nipple discharge may be a symptom of a serious medical condition.

Nipple discharge is always abnormal in men.

It’s important to have a healthcare provider examine your breasts and determine the cause of any nipple discharge.

What kind of nipple discharge is normal?

Nipple discharge may be OK if:

• It’s clear, yellow, brown, green or white.
• It comes from both breasts.
• It occurs only if you squeeze your nipples.
• It comes from several milk (breast) ducts.

Nipple discharge is typically NOT OK if:

• It’s bloody. Bloody discharge is almost always concerning.
• It comes out of only one breast.
• It comes out on its own (without you touching or squeezing your nipple).
• It’s accompanied by symptoms like breast pain, redness, swelling or changes to your nipple.

Nipple discharge color

Color isn’t very useful when it comes to diagnosing nipple discharge. White, clear, yellow and brown nipple discharge could be normal, but it could also be abnormal. Bloody or pink nipple discharge is usually a sign of a problem.

The color of your nipple discharge typically depends on the cause. For example, yellow discharge usually indicates an infection, while greenish brown or black may suggest mammary duct ectasia.

Texture or consistency may also be a factor in finding a cause for nipple discharge. Depending on the cause, nipple discharge can be thin, thick or tacky like glue.

What are the most common causes of nipple discharge?

Nipple discharge is rarely a sign of something serious, like breast cancer. Causes of harmless nipple discharge include:

• Hormonal imbalances or changes (like during menstruation or menopause).
• Pregnancy or breastfeeding.
• Medications, including birth control pills and some antidepressants.
• Noncancerous cysts.
• Nipple stimulation or friction from clothing.
• Sexual arousal.
• Injury to your breast.
• Stress.

Healthcare providers consider nipple discharge abnormal when it occurs spontaneously (not caused by breast stimulation), is bloody or only occurs in one breast. Health conditions that may cause abnormal nipple discharge include:

• Papilloma (noncancerous breast tumor).
• Breast infection or abscess.
• Mammary duct ectasia.
• Severe underactive thyroid gland (hypothyroidism).
• Pituitary gland tumor.
• Fibrocystic breast (normal lumpiness in the breast).
• Cancerous breast tumor (in rare cases).
• Paget’s disease of the breast.

It’s also normal for newborn babies to have a little nipple discharge. Hormones from during pregnancy cause this to happen. It should go away on its own within a few weeks. If you breastfeed, you may also leak milk-like fluid after ending breastfeeding.

It’s always best to check with a healthcare provider so they can rule out any serious conditions causing nipple discharge.

What does breast cancer nipple discharge look like?

Nipple discharge that’s bloody or clear may be a sign of breast cancer. This is especially true if it’s leaking from just one breast. People with nipple discharge due to cancer often feel a lump on their breast, as well. Still, breast cancer rarely causes most nipple discharge.

Does stress cause nipple discharge?

Yes. There are studies that show stress causes nipple discharge. This is due to increases in the hormone prolactin, which is responsible for lactation.

How is nipple discharge diagnosed?

Healthcare providers diagnose nipple discharge with a physical exam and discussion of your medical history. Tests they use to identify the cause of the discharge include:

• Imaging: Your provider may order tests like a mammogram (breast X-ray), ultrasound and magnetic resonance imaging (MRI) to help them find a cause.
• Biopsy: If a physical exam or imaging tests show an abnormality, your provider may take a sample of breast tissue for further testing.
• Hormone blood test: Your provider takes a blood sample to measure thyroid and prolactin levels.
• Ductogram: Your provider injects a contrast dye into your milk ducts and then looks at your ducts with a mammogram.

How is nipple discharge treated?

Treatment for nipple discharge depends on the cause. Your treatment may involve:

• Changing or stopping a medication.
• Removing a lump or cyst.
• Taking out a milk duct.
• Medications like antibiotics for breast infections.
• Treating the condition causing the discharge.

If there’s no apparent cause for your nipple discharge, you may not need any treatment. Leaving your nipples alone and not squeezing them may be the only treatment. Your healthcare provider may recommend a follow-up exam or mammogram just to be sure.

When should I be concerned about nipple discharge?

Nipple discharge is concerning when:

• You’re male.
• The discharge is bloody.
• It only comes from one nipple and not from both.
• It comes out even when you don’t touch or squeeze it.
• You also have a lump, breast pain or other unusual symptoms.

When should I call a healthcare provider about nipple discharge?

Contact a healthcare provider about any nipple discharge that’s new, that lasts longer than a few weeks or if the discharge:

• Comes from one breast only.
• Happens without breast stimulation.
• Is pink or bloody.
• Develops in a male.
• Occurs in a woman over 40.
• Is accompanied by a lump, redness or breast pain.

Nipple discharge is usually not cancer. Your healthcare provider can monitor your symptoms and discuss treatment for nipple discharge. In most people, nipple discharge goes away over time or with the right treatment.