It’s essential to understand that the majority of nipple discharge is either normal or caused by benign medical conditions. However, there are situations when breast discharge may be indicative of certain forms of breast cancer. The likelihood of this is higher if the nipple discharge originates from a single duct, is spontaneous (not triggered by compression or squeezing), is bloody, and is accompanied by a lump or mass within the breast. Additionally, an abnormal mammogram can further raise concerns. There are two types of breast cancers:
Intraductal carcinoma is a form of breast cancer that originates within the milk ducts of the breast, typically situated beneath the nipple. It causes symptoms such as a bloody or milky-white discharge, thickened or puckered skin, and the presence of a breast lump.
Paget’s disease is another rare type of breast cancer that can lead to nipple discharge. This condition begins in the breast ducts and subsequently involves the nipple. It may cause the nipple and the surrounding areola to bleed or secrete fluids. Other associated symptoms may include nipple tenderness or a burning sensation, as well as redness and scaling in the nipple area.
Diagnosis and treatment of nipple discharge
When you experience nipple discharge, your healthcare provider will typically conduct a series of tests to determine the underlying cause. The specific tests performed can vary depending on your age, the symptoms you’re experiencing, and the findings from a physical examination.
Blood Tests: Blood tests such as Prolactin level tests and TSH are taken into account. Prolactin tests
measures the amount of prolactin, a hormone involved in milk production, in your bloodstream. Elevated prolactin levels can be indicative of various underlying conditions, including hormonal imbalances. Whereas, TSH tests assess the activity of the thyroid gland to gauge their impact on one’s body.
Biopsy: In cases where there are lumps or abnormalities near the nipple, a breast biopsy may be performed. This procedure involves the removal of a small sample of tissue from the affected area for examination. Whereas, a skin biopsy is helpful for diagnosing conditions like Paget’s disease
Cytology: A sample of the nipple discharge is collected and examined under a microscope to detect the presence of cancer cells. This test can help determine if the discharge is associated with a malignant condition.
Ultrasound: An imaging test is used to identify any abnormalities behind the nipple and areola. This test can reveal papillomas, but a biopsy may be necessary to confirm the diagnosis.
Mammogram: X-ray images of the breasts are taken to assist in the detection of breast abnormalities or signs of cancer.
Ductogram: This test combines mammography with an injected contrast material to evaluate the breast milk ducts for blockages or growths. It can help identify the underlying cause of nipple discharge.
(Article Credits: Dr. Parul, Infertility Specialist, Nova IVF Fertility, Gurugram)
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