Summary about Disease
Unilateral nipple discharge refers to the spontaneous or expressed release of fluid from only one nipple. It is a relatively common condition, particularly in women of reproductive age, but can also occur in men, though less frequently. While often benign, it's crucial to investigate the cause to rule out underlying serious conditions like breast cancer. Discharge color and consistency can vary and may offer clues to the underlying cause.
Symptoms
The primary symptom is fluid discharge from only one nipple. Other associated symptoms may include:
A lump in the breast
Pain or discomfort in the breast
Skin changes around the nipple (redness, scaling, dimpling)
Inverted nipple (if it's a new development)
Causes
Possible causes of unilateral nipple discharge include:
Intraductal papilloma: A benign growth within a milk duct, is the most common cause.
Duct ectasia: Enlargement and thickening of milk ducts.
Breast cancer: Less commonly, discharge can be a sign of certain types of breast cancer, particularly ductal carcinoma in situ (DCIS) or invasive ductal carcinoma.
Infection: Abscess or mastitis.
Trauma: Injury to the breast.
Medications: Certain medications can stimulate prolactin production, leading to discharge (antidepressants, antipsychotics, some blood pressure medications).
Hormonal imbalances: Elevated prolactin levels (hyperprolactinemia) can be caused by various factors, including pituitary tumors.
Hypothyroidism: An underactive thyroid gland.
Stimulation: Excessive nipple stimulation.
Medicine Used
Treatment depends on the underlying cause. Some possibilities include:
Antibiotics: For infections (mastitis, abscess)
Hormone therapy: To manage hyperprolactinemia (e.g., bromocriptine, cabergoline)
Surgery: To remove intraductal papillomas or cancerous lesions
Pain relievers: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage breast pain
Is Communicable
Unilateral nipple discharge itself is generally not communicable. The underlying cause might be, but the discharge itself is not infectious in most cases. For example, if caused by an infection like mastitis, that infection itself is not usually communicable through the discharge.
Precautions
See a doctor: Prompt medical evaluation is essential for any nipple discharge.
Avoid squeezing the nipple: Excessive manipulation can worsen the discharge and cause irritation.
Breast self-exams: Regularly perform breast self-exams to monitor for any changes.
Follow doctor's advice: Adhere to prescribed treatments and follow-up appointments.
How long does an outbreak last?
The duration of nipple discharge varies depending on the underlying cause and treatment. If it's related to a medication, it might resolve after discontinuing the medication. For an infection treated with antibiotics, it should resolve within a week or two. In cases where surgery is needed, the discharge might persist until the underlying cause is addressed.
How is it diagnosed?
Diagnosis typically involves:
Physical exam: Breast examination by a doctor.
Medical history: Discussion of symptoms, medications, and medical history.
Nipple discharge analysis: Microscopic examination of the discharge.
Mammogram: X-ray of the breast.
Ultrasound: Imaging of the breast tissue.
Ductogram (galactography): X-ray of the milk ducts.
Biopsy: Tissue sample for microscopic examination.
Blood tests: To check prolactin and thyroid hormone levels.
Timeline of Symptoms
The timeline varies greatly depending on the cause.
Intraductal papilloma: Discharge may be intermittent or constant, with or without pain.
Duct ectasia: Discharge may be multicolored and sticky, often occurring in women approaching menopause.
Infection: Symptoms can develop rapidly (days) with pain, redness, and fever.
Cancer: Discharge may be bloody or clear, and other symptoms like a lump may develop over weeks or months.
Important Considerations
Age: Nipple discharge in women over 40 or in men requires careful evaluation.
Pregnancy and breastfeeding: Nipple discharge is normal during pregnancy and breastfeeding, but unilateral, spontaneous, or bloody discharge should still be evaluated.
Hormone replacement therapy: Can sometimes contribute to nipple discharge.
Anxiety: While usually not serious, nipple discharge can cause significant anxiety; reassurance and thorough evaluation are crucial.