Patient's question:
Not pregnant, milky discharge from the breasts when squeezed, usually does not flow. What illness is this? What tests should be done? Duration and onset of this illness: 3 months so far. General condition: Healthy. Past diagnosis and treatment history and effectiveness: None. Auxiliary tests: None. Other: InfertilityDoctor's answer:
Hello, nipple discharge is diverse and can be categorized into two types: physiological discharge and pathological discharge. Physiological discharge refers to lactation during breastfeeding, nipple discharge caused by oral contraceptives or sedatives, as well as minor nipple discharge in women before or after menstruation. This physiological discharge is mostly bilateral, multi-duct non-hemorrhagic discharge. Pathological discharge, as commonly referred to in clinical practice, is discharge caused by diseases, mostly presenting as unilateral, single-duct discharge (rarely multi-duct), which can be either bloody or non-bloody. The common characteristics of nipple discharge in clinical practice are as follows:1. Bloody Discharge: Red, dark red, or coffee-colored. The most common cause is intraductal papillary carcinoma. Bloody discharge is also more frequently associated with breast cancer, particularly intraductal papillary carcinoma. Therefore, individuals over 50 with single-hole bloody discharge should be particularly cautious. Duct dilation can also cause bloody discharge.
2. Serous Discharge: Thin, transparent, and light yellow. Most commonly caused by intraductal papillary carcinoma, it can also be seen in breast hyperplasia and rarely in breast cancer.
3. Watery Discharge: Thin, colorless, and similar to water. Less common, but it can also be caused by breast cancer and should not be ignored.
4. Milk-like Discharge: Milky white, ranging from light to thick. It can occur in women who have stopped breastfeeding months or years ago, in cases of breast hyperplasia, or due to certain medications. It is also commonly seen in pituitary tumors.
5. Purulent Discharge: Thick, yellow or greenish liquid, which may be bloody and resemble pus. This indicates inflammation and is more common in mastitis or duct dilation.
Diseases that cause nipple discharge include extramammary diseases and intramammary diseases. Extramammary diseases are primarily caused by hypothalamic-pituitary lesions, such as tumors, leading to hyperprolactinemia. Nipple discharge caused by extramammary diseases is mostly bilateral, multi-duct non-hemorrhagic. Intramammary diseases mainly include intraductal papillary carcinoma, duct dilation, proliferative changes, breast cancer, and inflammatory lesions.
It is recommended to undergo medical examination.