Topic: Nipple Discharge

Forum: Not Diagnosed But Worried — For those who are experiencing symptoms or received concerning test results, but haven't been diagnosed with breast cancer.

Posted on: Jul 29, 2017 06:43AM

Posted on: Jul 29, 2017 06:43AM

djmammo wrote:

from the American College of Radiology

"Nipple discharge is a common complaint that leads patients to breast imaging evaluation. At least 80% of women will experience at least 1 episode of nipple discharge during their reproductive years. Nipple discharge is the third most common breast complaint after breast pain and breast mass, with a prevalence of 4.8% to 7.4%, and accounts for 5% of all breast symptoms. It is categorized as physiologic or pathologic.

Pathologic nipple discharge tends to be unilateral, from a single duct orifice, spontaneous, and serous or bloodstained. Nipple discharge that exhibits any one of these features may be considered pathologic.

Physiologic nipple discharge tends to be bilateral, from multiple duct orifices, and white, green, or yellow in color. In a study by Goskel et al, nonspontaneous nipple discharge, which was frequently colored or milky, was differentiated from spontaneous nipple discharge, which was considered pathologic. In this study, none of the patients with nonspontaneous nipple discharge developed cancer on follow-up examination. In another study by Bahl et al, no in situ or invasive cancers were found in patients whose nipple discharge did not exhibit any of the pathologic features. If patient history and physical examinations demonstrate physiologic nipple discharge and routine screening mammography is up to date, no radiologic investigation is needed.

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
Log in to post a reply

Page 4 of 13 (130 results)

Log in to post a reply

Feb 1, 2018 11:25AM Elijahgirl wrote:

I just had my biopsy on Monday and this evening I had a lot of blood oozing from my nipple, I have had bleeding from this nipple before my biopsy but this moore than the usual norm. Should I be concerned?

Log in to post a reply

Feb 1, 2018 03:24PM djmammo wrote:

Elijahgirl

Bloody discharge from the nipple can be seen after such a biopsy as the needle crosses a duct. The growth in the duct that causes bloody discharge is extremely vascular and that can add to the bleeding. Sometimes if there is a hematoma or other post biopsy collection it can drain through the ducts for quite a while. You cannot lose enough blood to be harmful to you. The bleeding will certainly stop when you have the surgery to remove the biopsy target.

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
Log in to post a reply

Feb 2, 2018 10:43AM - edited Feb 6, 2018 12:24PM by AC719

This Post was deleted by AC719.
Log in to post a reply

Feb 23, 2018 03:47PM - edited Feb 23, 2018 03:48PM by MaggieCat

DJ - I had some crust on my left nipple two weeks ago. When squeezed a small amount of relatively milky liquid - I'd say from one duct. No discharge from other breast. I just checked and was able to express a very small amount of white-ish milky discharge from left breast, same duct. Have had itching in the nipple during this time. Haven't been too concerned other than the itching keeps me aware of the breast. Latest imaging 11/2017 - "stable". Should I be concerned?

Dx 10/16/2014, IDC, 1cm, Stage IA, Grade 3, 0/6 nodes, ER-/PR-, HER2+ Dx 10/16/2014, DCIS, <1cm, Stage 0, Grade 3, 0/6 nodes, ER-/PR-, HER2+ Surgery 10/30/2014 Lumpectomy: Left; Lymph node removal: Left, Sentinel Targeted Therapy 12/15/2014 Kadcyla (T-DM1, ado-trastuzumab) Radiation Therapy 3/18/2015 Whole breast
Log in to post a reply

Feb 23, 2018 05:59PM djmammo wrote:

MaggieCat

See my post a few paragraphs above dated Jul 29, 2017 07:43AM

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
Log in to post a reply

Feb 27, 2018 10:01PM Love27 wrote:

hi DJ,

You responded to my post on worries. I’ve gone for an mri and I am waiting for result. Since I have had prolactin, hormone, thyroid and para thyroid all come back clear, I’ve had only clear discharge in one breast from one duct with pain. But only when I squeeze. If my mri comes back noWhat else could it be? What other test should I ask for?

Log in to post a reply

Feb 28, 2018 06:11AM djmammo wrote:

Love27

The ductogram is the gold standard for evaluating nipple discharge of this kind. You may have to call around to find a center that does them often enough to do them well.

Click Here for more information

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
Log in to post a reply

Mar 1, 2018 03:42PM NSwrites wrote:

Hi DJMammo - my ductogram (galactogram - same thing, right?) was not able to be completed (other details in a comment above - one duct, one breast, brownish black). The radiologist could not get into the duct. My general practicioner says we don't need to do any followup. I pushed because I disagree, and he has referred me to a general surgeon. Any thoughts on whether a galactogram should try to be repeated when they can't get the needle into the duct, or what other tests might figure this out?

Log in to post a reply

Mar 1, 2018 04:23PM djmammo wrote:

Love27

Clear and bloody discharge are the types 2 we worry about. The MRI is very sensitive and can pick up very small abnormalities. If there is something bad there it should show up. If not and the discharge persists the next two choices are a ductogram or surgical duct exploration

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
Log in to post a reply

Mar 1, 2018 04:25PM djmammo wrote:

NSwrites

I usually bring pts back for at least one additional attempt at the ductogram after a week, making sure the pt doesnt try to express any fluid that whole time. Then hot towels on the breast for a while before trying again. We used a very bright light and magnifying lenses. After that an MRI if you have not had one yet

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com

Page 4 of 13 (130 results)

Scroll to top button