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Brown nipple discharge - so anxious

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peacejen
peacejen Member Posts: 23

Hello, I am 48 years old and very anxious. I’ve had a high prolactin level for as long as I can remember. I’ve had CT scans of my pituitary gland and it was normal. Due to this I’ve had discharge from my nipples for over 20+ Years. It’s varied from pale to yellow to greenish. My docs have checked my prolactin level several times over the years and never required meds/treatment. It’s always been just the way it is. I get a mammogram every year, occasionally have needed ultrasound and I’ve had simple and complex cysts . I also have fibrocystic breasts and once had a biopsy and it was a fibroadenoma. I’ve had normal mammograms yearly since 2012.This is my concern now:

03/2020 Mammogram, normal return in one year.

11/2020 Noticed dark brown discharge from left nipple in one duct. Other ducts are the same green/yellow/pale I have always had. I know it’s from one duct because, trust me, I’ve been obsessing. It does not come out by itself but always dose if I squeeze the nipple.

Questions - is brown always blood? I have an appt with gyne in two weeks, is that too long to wait? What should I ask/expect at appointment? Is papilloma more likely than cancer? Does anyone know statistics of papilloma vs cancer.

I’d appreciate anyone’s story, regardless of the diagnosis you received.

Thank you :)

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  • peacejen
    peacejen Member Posts: 23
    edited November 2020
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    I saw a breast surgeon and he examined the breast and armpit area, he also saw the discharge. He was not able to see discharge when he checked but I was able to compress nipple and show him. He was not concerned at all, but offered a diagnostic mammogram to appease me. I will have that in January. He said there wasn’t a reason to send discharge for pathology because he said it looked normal.

    Thoughts?

    Thank you

  • LivinLife
    LivinLife Member Posts: 301
    edited November 2020
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    I don't know about discharges Jen... sorry you did not receive any responses to your first post! I can't believe that much time passed and we missed it! Truly sorry. I'm glad you will have the mammogram in January for peace of mind. It sounds like the surgeon does not expect any issues from what you said. They truly are experts so you should be able to trust that. I hope you are not too troubled since you received that feedback even though I'm sure you have concern too. If anything concerning shows up on the mammogram they will follow up on that. They tend to be overly cautious- most follow-up's (about 80%) of even diagnostic mammograms are benign and 80% of those biopsied are benign... Please let us know your results!

  • barbara4
    barbara4 Member Posts: 10
    edited November 2020
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    Hi peacejen,

    I had brown serous nipple discharge. My prolactin levels were high as well. However, the discharge was not chronic as it seems to be your case. The discharge was unilateral and spontaneous. I had ultrasound, mammogram and a ductogram. I remember the radiologist saying that it could also be a papilloma or duct ectasia. I was finally diagnosed with DCIS and IDC. However, it doesn’t mean that thiswill also be your case.


    Good luck,

    Barb

  • jessigirl
    jessigirl Member Posts: 2
    edited November 2020
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    I had a spontaneous nipple discharge of brown nipple discharge with months of serous discharge that could be expressed. I just got my pathology report of intraductal pappiloma. Mine was a very firm almost hard like lump but I hear some are soft and some you can't feel at all. Prayer that your diagnosis will be the same Benign finding as mine was. It was a rollercoaster of a journey but I've learned so much! I pray if there is a next time I have a lump I won't be as nervous as I was this time. I’ll still be proactive to have it checked but there are soooo many benign things that can cause similar symptoms to cancer it’s can be scary.

  • peacejen
    peacejen Member Posts: 23
    edited December 2020
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    So, I went for a second opinion on my discharge with a breast surgeon. She was not able to express discharge but I was able to. She checked the discharge and it has blood in it. I had already scheduled a mammogram/ultrasound for early January. She said that timeline is appropriate and to keep my hands off my nipples and not try to express discharge. She said that if the ultrasound and mammogram are normal and the discharge has stopped that nothing else is needed. If the mammogram and ultrasound are normal but the discharge continues she will schedule an MRI.

    Does this all sound right as far timing? I can’t help but feel scared. This is no fun at all.


    Thank you for reading

  • peacejen
    peacejen Member Posts: 23
    edited December 2020
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    I’m bumping this, just because I’m so nervous

  • alicebastable
    alicebastable Member Posts: 1,945
    edited December 2020
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    I think your surgeon's advice to keep your hands (and mind) off your breasts is excellent advice until your appointment. Squeezing them might have caused internal irritation.

  • peacejen
    peacejen Member Posts: 23
    edited December 2020
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    AliceBastable, good advice and I’m doing my best. It’s so so tempting to ‘check and see’.

    Waiting is hard and stressful.


    Thank you :

  • LivinLife
    LivinLife Member Posts: 301
    edited December 2020
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    I agree with Alice.... Thanks for checking back in peacejen! Do what you can to do enjoyable relaxing things between now and January. Also check out some of the "lighter" posts on this site - there are threads with pics and some stories about cats and dogs and exercise and humor. I myself haven't done enough of that.... just some ideas if you're not sure what else to do with yourself....

  • peacejen
    peacejen Member Posts: 23
    edited December 2020
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    • Thank you for responding. Everyone here is so nice.
  • peacejen
    peacejen Member Posts: 23
    edited January 2021
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    So, just updating a bit. My symptom of bloody discharge is the same. My mammogram/ultrasound is on January 5th. Wonder what they will find?! If they don't find an abnormality, my breast surgeon told me we will wait another month and do an MRI. Why would I wait a month if the symptom is the same? I think if the radiologist doesn’t find anything at diagnostic mammogram/ultrasound I will ask right away for MRI order. Make sense?

    Thank you



  • LivinLife
    LivinLife Member Posts: 301
    edited January 2021
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    First off best with the mammogram/ultrasound a few days from now!! I think it makes sense to ask why wait a month. I imagine that may give time for authorization for the procedure, etc. Still makes sense to ask - if you need some kind of preauth that can happen quickly sometimes and other times can indeed take a while. I get annual tests for another medical issue. I often schedule those 1-2 months in advance b/c I have them done 4 hours away and coordinate those with other appointments in the same area. It has not been unusual at all that I call insurance a week or two before the actual test date and no one has even sought preauthorization (which is required). Then it's a mad scramble to get all that in order so I don't have to cancel. Thankfully there are really good and helpful people at my insurance company - we don't often hear or talk about these stories.... Not sure what else may hold up scheduling - maybe others will have some input on that....

  • peacejen
    peacejen Member Posts: 23
    edited January 2021
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    Ok, so I just had my mammogram/ultrasound. My left nipple is the one with bloody discharge. They didn’t see anything at the nipple but they did see an area they want to biopsy a bit away from nipple. On the left side where I don’t have bloody discharge they saw what may be a papilloma and want to biopsy that too. I asked the radiologist what birads she was giving me and she said 4a.

    I’m more scared now as they saw an area they want to biopsy that I wasn’t even aware of, and on the right side that I wasn’t even thinking of, they want to biopsy too.

    The biopsy isn’t until February 3rd, results given in 2 days.

    Thanks for listening

  • peacejen
    peacejen Member Posts: 23
    edited January 2021
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    Hello everyone,

    I wanted to update and get some feedback. I had my diagnostic mammogram and ultrasound 2 days ago and received my report. I'll post it here. I've looked up many words from it, I'm so anxious. I am not eating or sleeping normally. Here it is...

    The tissue of both breasts is heterogeneously dense. This may lower the sensitivity of mammography.

    Digital Breast Tomosynthesis (DBT) images were obtained and used to assist in the interpretation of this examination.

    Ultrasound demonstrates 1.1 cm x 3 cm x 8 cm oval intraductal hypoechoic mass with a circumscribed margin in the right breast at 11 o'clock in the retroareolar region. Color flow imaging demonstrates that there is no increase in vascularity. This abnormality was not seen mammographically.

    There is 1 cm x 0.4 cm x 0.7 cm oval hypoechoic mass with cystic components in the left breast at 1 o'clock in the retroareolar region. This abnormality was not appreciated mammographically.

    There is an ectatic left retroareolar duct with internal mobile debris measuring 1.4 x 0.4 x 0.2 cm. Upon squeezing the duct it demonstrated decreased size due to fluid discharge. The discharged fluid appeared yellow in colour.

    Sonography of both axilla reveals normal appearing lymph nodes.

    Incidental note was made of several simple cysts at 2:00 5 and 6 cm from the nipple largest measuring up to 1.2 cm.

    No other significant masses or calcifications are seen in either breast on the mammogram or bilateral ultrasound.


    IMPRESSION: SUSPICIOUS OF MALIGNANCY, ULTRASOUND SUSPICIOUS OF MALIGNANCY
    The 1.1 cm intraductal mass in the right breast at 11 o'clock in the retroareolar region is at a low suspicion for malignancy. An ultrasound guided biopsy is recommended.

    The 1 cm oval mass with cystic components in the left breast at 1 o'clock in the retroareolar region is at a low suspicion for malignancy. An ultrasound guided biopsy is recommended.


    Continued clinical and surgical follow up for bilateral nonspontaneous nipple discharge is recommended. Further management pending biopsy results.

    Mammogram BI-RADS: 4a Suspicious abnormality - low suspicion for malignancy Ultrasound BI-RADS: 4a Suspicious abnormality - low suspicion for malignancy


    Any insight, encouraging or not, is welcome.

    Thank you.

  • melissadallas
    melissadallas Member Posts: 929
    edited January 2021
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    Both have the characteristics of benign masses (oval, circumscribed, cystic...) and the report iterates “low suspicion.” Duct ectasia is just when cellular debris accumulates in our ducts as we age, widening the. As Beesie told you in your other thread, this is not anything to not be able to sleep or eat over

  • LivinLife
    LivinLife Member Posts: 301
    edited January 2021
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    Truly peacejen - this sounds promising.... It makes sense you have some worry - these kinds of processes are anxiety-provoking though focus on the cyst-related statements and 4a BIRADS.... I hope these hold for you! The vast majority of the time they do....

  • peacejen
    peacejen Member Posts: 23
    edited January 2021
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    Mind one more question from me? I'll take that as no you don't mind. LOL

    This concerns me a lot - Ultrasound demonstrates 1.1 cm x 3 cm x 8 cm oval intraductal hypoechoic mass

    8 cm?!? Isn't that huge? How can that not show up on a mammogram? Also, isn't the height bad, and taller than wider is worse?

    I googled (I know) and 8cm seems to be bad. Like stage 3c bad. My head is spinning, I apologize.

    Jen


  • melissadallas
    melissadallas Member Posts: 929
    edited January 2021
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    Could be a typo and be .8 not 8.

    What matters:

    “The 1.1 cm intraductal mass in the right breast at 11 o'clock in the retroareolar region is at a low suspicion for malignancy. An ultrasound guided biopsy is recommended.

  • peacejen
    peacejen Member Posts: 23
    edited January 2021
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    So, as I mentioned I was very concerned about the size of a mass seen on ultrasound.

    It was reported as 1.1cm X 3cm X 8cm. I sent a message to my breast surgeon about my concern. She replied it was a typo and she contacted the radiologist that wrote the report. Then I received the below.

    AMENDMENT: 1/8/2021
    Amendment to the body of the report: Ultrasound demonstrates 1.1 cm x 0.3 cm x 0.8 cm oval intraductal hypoechoic mass with a circumscribed margin in the right breast at 11 o'clock in the retroareolar region.

    I know that there is no answer until the biopsy results come, but can I take some reassurance from the amendment to the report?

    Thank you MelissaDallas for suggesting that it might be a typo, it prompted to check with my doctor.

    Jen

  • melissadallas
    melissadallas Member Posts: 929
    edited January 2021
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    Certainly you can take assurance from that, and (again) from the fact that everything points to a very low level of suspicion

  • peacejen
    peacejen Member Posts: 23
    edited January 2021
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    Okay, so I have made it almost two weeks without posting, that is a record for me LOL. I have 2 more weeks until my biopsies and I am doing my best to try to relax until then, I am occasionally successful. I just checked on my nipple discharge and there was so much. I have been trying to keep my hands off and let things be, but today I did manipulate to see if the discharge was the same. There was a large amount of creamy yellow with brown discharge. It was not spontaneous but I was surprised at the amount. Perhaps the amount was because I have been leaving the breast alone. This the same one duct discharge that brought me to a breast surgeon and mammogram/ultrasound to begin with. During the ultrasound I was able to express some and this was written about the area -

    There is an ectatic left retroareolar duct with internal mobile debris measuring 1.4 x 0.4 x 0.2 cm. Upon squeezing the duct it demonstrated decreased size due to fluid discharge. The discharged fluid appeared yellow in colour.

    I don't really know what to think of this amount of discharge. I have been reading these boards every day and wanted to post for any thoughts. I know there won't be answers until the biopsy.

    Thank you for reading.


  • melissadallas
    melissadallas Member Posts: 929
    edited January 2021
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    I personally think that the doctors may believe that the squeezing you keep doing is what is causing the slight amount of bleeding along with the discharge that may be perfectly normal. You need to quit squeezing until they evaluate you.

    What have you learned about breast discharge by reading every day? I can’t think of anopyone else experiencing your same situation

  • peacejen
    peacejen Member Posts: 23
    edited January 2021
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    I know, stop touching. That is why I didn't for nearly two weeks. I think I was hoping when I checked today it would be gone.

    What I have learned about breast discharge is that it is more concerning if it is unilateral, spontaneous, one duct, bloody. Also, I have learned that it often benign. Probably the same stuff most people on here already know.

    By checking in on these boards everyday I have also learned that this a great site with supportive women who don't sugar coat and and give real information and support.

    Jen

  • LivinLife
    LivinLife Member Posts: 301
    edited January 2021
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    You're getting there peacejen.... : )

  • peacejen
    peacejen Member Posts: 23
    edited January 2021
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    Thank you LivinLife.

  • minustwo
    minustwo Member Posts: 13,129
    edited January 2021
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    Yup Peacejen - What Melissa said may be right - you could be aggravating the situation and keeping making it worse. Glad you're here and glad if we can help - but QUIT TOUCHING.

  • peacejen
    peacejen Member Posts: 23
    edited January 2021
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    Hello!

    So, now I am three days away from my biopsies. The past 26 days of waiting have been tough. I've taken advice from those in this board, I've been staying busy and doing some fun stuff. My anxiety has kicked up a notch as I will have my results on Friday. I'm just checking in here. Sending positive vibes to all :)

    Jen

  • LivinLife
    LivinLife Member Posts: 301
    edited January 2021
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    It sounds like you've been doing good self-care - I'm so glad... It also makes sense your anxiety is getting higher now that result time is closer - pretty normal.... I find with long waits (usu for a follow-up test) I have trouble for some days or even a week after the test, then do well the time in between and then more nervous about 2 weeks from the next re-scan or re-test.... It's in the foreground now peacejen so on your mind more... Glad you checked in! Keep up all you are doing.... Obviously let us know.... Best!

  • peacejen
    peacejen Member Posts: 23
    edited February 2021
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    My biopsies are tomorrow, it’s been a long 4 week wait. After my biopsies tomorrow do keep posting here until I get results Friday or move to the waiting for results section?

    Positive thoughts please :)


    Jen

  • moderators
    moderators Posts: 8,089
    edited February 2021
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    Jen, we are sending the best to you! It’s totally fine to keep the conversation here — it will help keep your posts in context and you won’t have to repeat yourself.

    Keep us posted!