Nipple Discharge
Comments
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In addition to the list you made, small bubbles introduced into the duct during the ductogram present as filling defects but they are usually recognizable as bubbles.
Your history is not classic for an intraductal papilloma. The most convincing history is spontaneous unilateral blood from only one duct on several occasions. One finds blood in the bra at the end of the day for example. If the blood comes from squeezing, it doesn't count since that is trauma. Likewise the mammogram compression is technically trauma and there is a small chance that caused the bleeding. Was blood identified coming from one duct when they did the ductogram? Thats how we know which duct to image otherwise its just a guess.
Also, in my experience having done many many ductograms over the years, there have been two times when the ductogram appeared to be grossly abnormal with multiple fixed filling defects present, all of which had completely disappeared when the ductogram was repeated on the day of surgery. No explanation for either case.
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Thank you for your reply. They had to really try, but after a lot of squeezing they were able to get blood from the duct to identify it for the ductogram. They also put some of it on slides which came back benign. You said that a papilloma usually causes spontaneous bleeding, is it the same for DCIS? And just to confirm, you believe it is possible for the things I listed to cause filling defects: Ectasia, fibrocystic changes, debris, or even little blood clots from the bleed? That would put my mind at ease a bit.
One last question... I have a lot of bruising and a hematoma from the biopsy... I’m an easy bleeder. Will the hematoma interfere with the MRI? It’s getting much better using warm compresses.
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I have biopsy on Monday but the lump beside my nipple (that didn't show up on mammogram or ultrasound except for calcifications) when I press down on the lump a yellow discharge comes out. What does this sound like? If it didn't show up on scans? The discharge always comes out at the same spot on nipple and it doesn't take much pressure
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Bloody nipple discharge is not a key feature of DCIS. It is usually found initially as calcifications on mammo.
For me personally, squeezing the nipple to produce bloody discharge just confuses things as the blood can be from the trauma of squeezing and not from a papilloma.
Yes debris can cause filling defects.
Before your MRI make sure they know you have one before they scan you so the person reading the scan knows ahead of time as it will be visible.
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This is more of a clinical than imaging topic since it does not show up on imaging. I would ask the doc when you go for your biopsy.
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I had my MRI today, the doctor called tonight and said everything looks great! No sign of whatever caused the ductogram filling defects 2 weeks ago. She said the same thing you said, DJ, that the trauma of the mammogram compression combined with my inflamed ducts probably caused the bleeding. I haven't bled since that day, but I am to call her if I do. She also wants me to come in 4 months for a follow up mammogram and ultrasound, and then in 6 months for another mri... just to check for any post biopsy changes. I'm not sure what that means but she said it's routine? Needless to say, I'm very relieved tonight. It's been a scary 2 weeks. I'm grateful for this site and especially DJ for your help.
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Yes its quite routine, and you're welcome. :-)
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Hi everyone , I am new to this forum and this is my first post. I am a 35 years old female.I have a 12 year old son and my husband passed away from colon cancer 7 years ago. 5 years ago I started having right breast nipple discharge that looks clear transparent yellow. I got an ultrasound and they also checked the nipple discharge which all came back normal. I continue to have the nipple discharge and still have it only when I squeeze a certain part of the areola part of my nipple but every time I do the discharge is there. Now aside from the discharge I have a tingling , electric shock like pain on the side of the breast that is leaking. It kind of feels like when milk is coming down or like when mastitis is develop.. I feel feverish and check my temp this morning and it was 99.6 by breast continues leaking when I squeeze the areolar part and the yellow clear discharge is coming only from one duct. I have lost my insurance and I am really scared , mainly scare because my son already lost his dad and I am all he has left. I am in the process of getting new insurance and will see a doctor soon but does anyone know if this can be a strong signed of breast cancer. I havent told anyone about this and I cry all the time because of it and starting to get depress.Thank you.
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Mari, I am so sorry you are under this stress also. I am 36 and in the process of waiting to see a breast specialist/surgeon. I too have that pain on the side of my breast that is affected. My discharge I first noticed in my bra. I then gently squeezed and saw clear fluid coming from 2 ducts. The fluid was clear with just a bit of cloudiness. After a few weeks I was again noticed discharge in my bra. This time when I checked the discharge it came from only one duct and was completely clear, no sign of color at all. It was also sticky, which I found odd. After a few more weeks I noticed a dark brown discharge in my bra twice. I again checked my nipple and that same duct now had dark brown sticky discharge. When I went in to see the doctor they told me they were concerned about the discharge due to it coming spontaneously in my bra. They tested the discharge and it tested positive for blood. My diagnostic mammogram and ultrasound were negative for any abnormalities. After the negative diagnostic imaging my doctor consulted a breast specialist and she requested to see me. They told me most of the time my symptoms are caused by a benign papilloma in the duct, though it can also be a sign of cancer. My doctor said on the phone if the discharge had not been spontaneous in my bra or contained blood they would be satisfied after the negative imaging. I am also considered high risk due to my family history, so any breast changes I have are thoroughly looked into.
I am glad you plan to get it checked out! Based on my conversations with my doctor, concerning discharge is spontaneous (not squeezed) and clear or bloody. I would still 100% get it evaluated by a doctor, but I hope you can take a deep breath and know your symptoms are not the typical ones associated with cancer, at least according to my conversations with my doctor.
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I have a concern to add. This happened out of nowhere this morning. I got out of the shower and noticed blood on my hand, couldn't figure out where it was coming from and then I realized it was my nipple. It is one tiny spot on left side of my nipple on left breast. It was leaking red red blood pretty good. I was squeezing it a bit to see what was going on with me I saw a tiny bit of almost reminded me ornament breast milk (I nursed two babies for a year each, but the last was 3 years ago or more now). There was barely any of what seemed like milk and it came from the center (different area than blood). I now notice a pain feeling to the left of the spot the blood came from on the breast part. It feels a Lot like when I was nursing and would have a clogged milk duct. Freaking out!
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Thank you Carrisa , I am going to get it checked out , I been crying everyday.
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Recently( about a month) I have noticed nipple discharge( left breast, clear, but looks yellowish on tissue) at first it only happened when my nipple or breast is squeezed. I have had a mammogram that was normal and I have been seen by my gynecologist. She suspects fibrocystic breast. She told me to leave my nipple and breast alone( don't keep checking for discharge) I have been good about that, but now I notice that it seems to be coming out spontaneously. This started to worry me. I messaged my doctor, but she didn't seem concerned. She did recommend that a see a breast specialist to follow up. My appointment is 3 days. I'm trying to stay calm, but every time I see the discharge I get worked up again. Logically, I know I just need to wait and see what the breast specialist says. I do have dense breasts so I worry that the mammogram missed something.
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Remember we worry about unilateral spontaneous bloody or sometimes clear discharge. Squeezing doesn't help as you could rupture a small vessel and see blood.
Most common scenario is incidentally noticing blood in one bra cup at the end of the day.
Even if it is bloody its usually a papilloma and they're usually benign.
Bottom line is the discharge needs to get worked up, but YOU don't. ;-)
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Ultrasound showed something in a duct. Doctor suspects intraductal papilloma. I am getting biopsy tomorrow. Hoping for good news from the biopsy.
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My discharge was oil coloured most times, sometimes clear, then ended up bloody. Hard to say if it was the cancer or not as I had a duct excision and there was also a papiloma in the duct as well. It's a toss up for sure at this point
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my aunt is in her 50’s and she still has discharge. Almost like she’s lactating. She’s had it checked out and it’s just an odd thing and every body is different. It’s been happening to her for years and she had two kids her are now in their 30’s
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Right now the positive is I now know the cause of the discharge. I'm glad the breast specialist had the ultrasound done because the breast exam and mammogram were normal. Obviously, I'd rather not have any of this, but I think it was detected early and papilloma seems small(4mm). All I can say is if you have any breast changes, please get it checked. Now, I'm just praying the biopsy is benign!
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I noticed some nipple discharge from my left nipple about a week ago after I got out of the shower. My nipple felt wet and I noticed a spot on my shirt. I ignored it and the next day noticed it again after getting out of the shower. At this point I can squeeze my breast and it will drop out. It is one duct and color is clear but tinted yellow. Appears yellow on a white tissue. I got my period two days after this began and saw my gyn who was able to express the discharge by gently pressing on my breast but didn’t fell a lump. It has slowed since and my period just ended. I can still squeeze my breast and there is discharge. Waiting on an appointment for mammo and u/s. TSH and prolactin levels are normal. Concerned this is cancer. Wondering what else could be and if anyone has had similar sympto
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CR2 did you ever get an answer as to what was
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just had my mammogram and ultrasound today. They noticed a 1 cm well circumscribed area in a duct. Said they thought it was debris or a papilloma. biopsy scheduled for 9/20. any thoughts on what this could be
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Hai may i knw how is your condition now? Im always having the same sign like you. Itchy and milky nipple discharge.
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I have my biopsy this Friday 9/20. The radiologist seeme sure that it was either debris or a papilloma but I’m concerned that it is DCIS or something else. Not sure how they can be so certain. I will update after I get results.
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I got my biopsy results back and it is a benign papilloma. They said that they like to remove thoseso I have an appointment with BS next week.
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Has anyone had the bloody discharge AFTER a NSM? My initial US and MRI came back negative but I’ve been having the discharge for almost two years. Now I just had another negative US but am waiting for my MRI results from last week.
I’m so nervous because my Dr has said she never seen this after Mastectomy.
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I have had off and on bouts of dark brown discharge. My Breast Surgeon said its ok if it isnt bloody. So I unfortunately noticed it was bleeding this week. I didnt know if it was from being dry (since it is flaky) or coming from the ducts. I gave the nipple a pinch like the Dr has to evaluate (I know not to do this but I did it to investigate) The blood came from multiple ducts. So I had an order out for my annual with diagnostic workup on this breast because we have been watchful for 4 years now, so I went ahead and scheduled my exam, but they cant see me until 11/15. Should I call my surgeon to update him or just wait for imaging?
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The surgeon would need the imaging to help make a decision so perhaps make an appointment to see them after the imaging is completed.
Also, don't squeeze the nipple. Press around the areola like a clock face from 12 to 1 to 2 etc and see at what location the discharge occurs. This helps us tell where to concentrate the ultrasound exam.
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59 yrs old. As background, I have Hidradenitis Suppurativa (3 cysts and 2 fistulas removed/repaired this year so far >1cm and <2cm), Right Clear Cell Renal Cell Carcinoma with partial Di Vinci Robotic surgery ( 2.5cm Grade 2 Stage 1) almost 2 years ago and am Multigoiter with Endo Dr watching a suspicious .07mm cyst (TI RAD Score of 4) for possible Thyroid cancer. I literally have more cysts than I know about both inside and outside my body from head to toe / front and back.
Spontaneous left nipple discharge off and on for 5 years. Was milky and over the last 2-3 years changed color. Brownish and thin. Went to PCP. She found several 'lumps' in both breasts, but one in the left breast 6:00 position had her concerned. I had Mammo Bil Diag w/Tomo/CAD, Breast Unilateral Limited* on 10/22/2019. I believe that the Rad Dr did absolutely not give enough information in his report for me to make an informed decision regarding my next step and did not address my discharge issue. He gave me a Bi-Rad 3. My PCP wanted to just 'follow things for the next 6 months." I have taken matters into my own hands and have an appointment Nov 11th with the breast surgeon. Having already been down the Cancer road and maybe looking at it again with my Thyroid, I don't do well with "MAYBE, POSSIBLY, PROBABLY" I need 100%.
djmammo, would you mind telling me if you agree that not enough information was given? Also, am I correct in that fibroadenoma can not be positively identified/diagnosed without a biopsy? Thank you.
FINDINGS:
This exam was performed on digital equipment and in addition to being interpreted by a Board Certified Radiologist.
MLO and CC views of bilateral breasts were obtained. As part of the interpretive process, the mammographic images were analyzed with a computer-aided detection system. Tomosynthesis imaging was obtained and reviewed as part of this examination.
There are scattered areas of fibroglandular density. There are focal areas of nodularity noted within the slightly upper outer left breast, lower outer left breast, and inner left breast. These demonstrate well-defined margins on tomo synthesis images. No suspicious focal lesion is noted within the right breast.
There is no architectural distortion or skin thickening.
The background parenchymal activity is symmetric. Benign calcifications are noted bilaterally.
Ultrasound imaging of the left breast demonstrates a small hypoechoic focus at the 6:00 region of the left breast 4 cm from the nipple measuring 0.3 x 0.4 x 0.5 cm. This most likely represents a small cyst with debris. Within the 3:00 region there is a hypoechoic nodule with sharp well-defined margins measuring 1 .0 x 0.5 x 0.7 cm. This is wider than tall. Imaging features are most consistent with fibroadenoma. Within the 4:00 region of the left breast there is a anechoic focus measuring 0.5 x 0.3 x 0.4 cm consistent with a cluster of cysts. A similar focus is noted at the 9:00 region measuring 0.8 x 0.4 x 0.7 cm suggestive of a cyst.
ORDER # 1022-0035 US/Breast Unilateral Limited*
IMPRESSION:
Probably benign. Multiple areas of nodularity are noted within the left breast on mammographic evaluation. These appear to correlate with probable cysts as well as a suspected fibroadenoma as described above.
Six-month follow-up left breast mammogram and ultrasound are recommended to monitor stability and assure benign nature of these lesions.
BIRADS CODE: 3 - PB6 - Probable Benign: Recommend 6 month follow-up.
ORDER # 1022-0027 MAM/Mammo Bil Diag w/Tomo/CAD
IMPRESSION:
Probably benign. Multiple areas of nodularity are noted within the left breast on mammographic evaluation. These appear to correlate with probable cysts as well as a suspected fibroadenoma as described above.
Six-month follow-up left breast mammogram and ultrasound are recommended to monitor stability and assure benign nature of these lesions.
BIRADS CODE: 3 - PB6 - Probable Benign: Recommend 6 month follow-up.
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