Yellow discharge from nipples. The main causes of discharge from the nipples. Treatment for abnormal discharge

Smirnova Olga (gynecologist, GSMU, 2010)

Women's mammary glands are very vulnerable to various diseases. If some disorders are caused by age, then others occur even in young girls. Discharge from the chest is one of the first signals of the development of pathology. Knowing the characteristics of normal and dangerous fluid from the nipples, as well as the causes of discharge, a woman will be able to pay attention to her health in time and begin treatment under the supervision of a doctor.

When a sign does not indicate a pathology

There are discharges of a non-hazardous nature for the following reasons:

• a specific period of the monthly cycle ();
• increased arousal during intercourse (orgasm);
• bearing a child (the body is preparing for lactation);
• lactation;
• addiction of the glands after weaning the child from the breast;
• puberty (in adolescents).

The appearance of a liquid substance from the nipples is not typical for every woman. Has a big impact:

• age;
• number of pregnancies;
• the state of the hormonal background;
• heredity;
• general health.

The appearance of transparent discharge from the mammary glands often causes:

• hard pressure on the areola or breasts;
• hormone therapy;
• taking contraceptives;
• wearing an inappropriate bra;
• physical stress;
• procedures in the hospital (ductography, mammography, etc.);
• treatment with antidepressants;
• lowering blood pressure;
• recent medical, surgical, or spontaneous abortion.

But the secreted liquid should not have a characteristic color, smell and cause pain. Doctors recommend seeking advice if the situation is noted constantly, and the volume of the secret increases.

How do discharges occur?

While carrying a fetus, a woman notices a gradual increase in the bust due to the high production of the hormone prolactin, which causes increased generation of glandular tissue.

Colostrum-like discharge is noted just before childbirth, but situations are not excluded when a yellowish or white liquid occurs in the second trimester. After the birth of a child, it takes several days for milk synthesis to begin.

The following signs may indicate a pathology:

• fluid production from one breast (left, right);
• breasts grow unevenly in volume;
• feeling of heterogeneity (tuberosity) of the bust;
• very pale or reddened skin of the chest;
• discharge provoke discomfort (general weakness, high temperature).

Such symptoms indicate that a woman needs to urgently go to the hospital and get tested. The doctor will be able to identify the failure in time and prevent problems with bearing the fetus.

After lactation

The non-dairy nature of the liquid from the nipples after the woman has stopped breastfeeding the baby is characterized by the following features:

1. First months. The appearance of milk is allowed, the production of which should disappear on its own in 2-3 months. It is advisable to gradually wean the child from breastfeeding.
2. One year later. In some women, the appearance of liquid from the nipples can be observed for up to a year. In some cases, the doctor prescribes special drugs (Bromocriptine, Parlodel, Dostinex).

There is no need to panic if when you press the nipples, liquid is released after feeding. For some time, prolactin is produced in large quantities, so the appearance of white discharge from the nipples will be noted until the body gradually returns to the prenatal norm.

Short term hormonal changes

Discharge from the mammary glands with pressure is often a consequence of taking birth control pills or treatment with hormonal drugs. The body will get used to the new state within the first three months. If during this time the situation does not stabilize, then it is necessary to consult a doctor about replacing tablets or stopping therapy.

You can talk about the end of the adaptation period if only a small amount of clear liquid is released from the nipples.

Why does pathology occur?

In normal health, a woman can see fluid from her breasts if she presses on her nipples. Their stimulation leads to the production of oxytocin, and it is this hormone that provokes the contraction of the milk ducts and the appearance of one or two drops from the nipples.

The causes of discharge from the mammary glands with pressure are often associated with a variety of pathologies.:

• chest injury;
• hormonal disruptions;
• galactorrhea;
• inflammatory process;
• intraductal papilloma;
• breast cyst;
• ectasia;
• fibrocystic disease (mastopathy);
• malignant tumors;
• nipple cancer;
• abscess;
• mastitis.

Hormonal disruptions

The endocrine glands are responsible for regulating hormonal balance. Therefore, discharges from the mammary gland are observed when the normal functioning of the thyroid gland and pituitary gland is disturbed, when the content of prolactin rises in the blood.

A high level of the hormone responsible for lactation is noted against the background of thyroid dysfunction and pituitary adenoma. Because of these diseases, the liquid from the nipples resembles milk, does not contain blood clots or pigments.

The appearance of white or transparent discharge from the chest associated with endocrine diseases is often accompanied by unstable periods. In some women without timely treatment, monthly menstruation disappears altogether.

To aggravate the state of the endocrine system can:

• bad habits (cigarettes, alcohol);
• systematic viral diseases;
• lack of sleep;
• malnutrition;
• harmful environmental conditions;
• high fatigue;
• hormonal drugs.

Galactorrhea

A similar disease causes a condition in which the release of fluid from the mammary gland is not preceded by a period of lactation. The occurrence of milk or colostrum in a non-pregnant or lactating woman is most often associated with endocrine disorders, but other causes are not excluded:

• problems with the central nervous system;
• hyperprolactinemia;
• malignant tumor of the pituitary gland;
• violation of the production of hormones by the adrenal glands;
• tumors in the adrenal glands;
• dysfunction of the hypothalamus;
• problems with the ovaries;
• abuse of herbal remedies and drugs.

The doctor selects the treatment of galactorrhea based on the results of the diagnosis of the brain, thyroid gland and other prescribed tests.

Mechanical damage

Injury to the chest without damaging the skin is characterized by the appearance of bloody discharge from the mammary gland and pain in the affected area. Damage provokes a blow to the steering wheel of a car, a push in the crowd, sharp pressure, bruises.

Unpleasant symptoms, including profuse or spotting fluid with blood from the nipple, are noted for two days, and then should disappear. If the situation does not improve, then the woman should go to a medical facility for examination.

A serious injury often provokes an abscess, against which a subcutaneous accumulation of pus occurs. But do not confuse purulent clots with yellow discharge, which indicates a gradual full healing.

Mastitis or abscess

These diseases are often confused with each other due to similar symptoms and occurrence factors, but there is a difference:

1. Mastitis. Inflammatory process in the female breast without a clear localization.
2. Abscess. Accumulation of pus in the mammary gland, limited to the capsule.

An infection can get in the following way:

• damage to the nipple after feeding the baby;
• infection during trauma.

Another inflammation provokes:

• milk stasis;
• bust hypothermia.

It is not difficult to detect the basic sign of pathology. It is easy enough to press on the nipples in turn, after which a certain amount of yellowish or greenish discharge from the chest with pus will come out.

In addition to purulent discharge from the chest, the following symptoms may appear:

• an increase in the volume of the gland;
• redness of the skin;
• a sharp increase in body temperature;
• pain in the bust area;
• fatigue.

In the initial stage of the disease, antibiotic-based therapy may be sufficient, but severely advanced cases are a reason for surgical opening of the lactiferous ducts, followed by removal of accumulations of pus.

Mastopathy

Most often, it is distinguished by the appearance of yellow discharge from the chest, which can become cloudy. And also sometimes a green liquid is noted in patients, and in the most advanced cases, the occurrence of dark discharge from the mammary glands is not excluded.

Additional symptoms:

• swelling of the bust;
• painful sensations;
• hormone problems.

ectasia

The expansion of the milk ducts is a consequence when the channels, for various reasons, were able to release a large amount of thick fluid. If the disease is accompanied by an inflammatory process, then the girl may notice a small amount of green discharge from the mammary glands when pressed.

After forty years, the expansion of the milk ducts is distinguished by bloody, brown and black discharge from the mammary glands.

Breast papilloma

This neoplasm is benign in nature and against its background a liquid of a wide variety of colors can stand out. It is formed between the juice itself and the beginning of the lactiferous duct. An important symptom is the occurrence of thick bloody discharge from the chest with a dark or brownish tint, often with piles of pus.

Crayfish

With tumors of a malignant nature, discharge from the nipples rarely occurs. There may be light, pink, clear, greenish, yellow, and bloody drops from the nipples. It is very difficult to diagnose cancer by liquid, because other less dangerous pathologies are also characterized by red and yellow discharge from the mammary glands when pressed.

Associated symptoms:

• inverted nipple;
• bust deformity;
• the presence of seals;
• enlarged lymph nodes;
• pressure pain.

The appearance of red, gray, yellowish and green discharge from the mammary glands should be taken seriously, but without unnecessary worries. Sometimes even a banal thrush against the background of dysbacteriosis causes liquid mucus from the nipple. Doctors advise systematically conducting self-examinations, visiting a mammologist annually for prophylaxis, and assessing fluid from the breast only against the background of pathological symptoms of a particular disease.

Discharge of pus from the nipple is not only an extremely unpleasant, but also a very dangerous symptom, which should alert and force you to immediately consult a doctor. And to know what to expect, find out the possible causes of this phenomenon.

First, it is worth noting that pus is an exudate resulting from purulent or serous inflammation of tissues. Such a liquid has a viscous consistency, a yellowish or grayish tint, and often an unpleasant odor. It consists of leukocytes, cholesterol, globulins, fats, albumins, particles of skin and soft tissues, DNA impurities, as well as enzymes and waste products of inflammatory pathogens - pathogenic microorganisms.

Given the above, we can conclude that pus does not form in the chest just like that, its accumulation and release is preceded by an inflammatory process. And in most cases, pathological changes occurring in the tissues of the mammary glands do not go unnoticed and provoke a number of other symptoms:

• puffiness
• hyperemia
• bursting
• discomfort
• soreness
• redness
• engorgement
• burning

Pus can be released from the nipples only when exposed to them (for example, when pressed) or flow freely if its amount is significant.

Non-purulent discharge that may cause anxiety

Far from always, the discharge is purulent, although sometimes in consistency and shade they really resemble pathological exudate. But if the leakage of fluid from the nipples is not accompanied by severe and obvious inflammation, and there are no other symptoms, then most likely it is not pus.

Possible situations in which a liquid similar to pus may be released from the nipples:

• Pregnancy. In the second half, colostrum begins to form in the breast, which the expectant mother can notice on her underwear. Its release does not cause concern, and the liquid itself has a rather thick consistency and a yellowish-transparent color.
• Lactation. Milk leakage between feedings is quite normal and should not be a cause for concern.
• If the discharge is very scarce and extremely rare, almost transparent or slightly yellowish, has no smell and is released when you press the nipples, then this can also be considered a variant of the norm. In the mammary glands, even outside the lactation period, a small amount of a special secret is secreted, which can go out through the milky tubules. The volume of discharge can increase with overheating, with intense physical exertion, as a result of stimulation of the mammary glands, or after certain procedures.
• Galactorrhea is the spontaneous secretion of milk outside the period of breastfeeding. Normally, it can be released for some time after the end of lactation, but, as a rule, no longer than 6-12 months (in some cases, 1.5-2 years). If a woman has not been breastfeeding for a long time, and even more so she has never fed, then galactorrhea is caused by hormonal disorders, namely, an increase in the level of prolactin responsible for lactation. An increase in its amount in the body may be the result of an abortion or miscarriage, taking oral contraceptives and other hormonal drugs, diseases of the thyroid gland, adrenal glands or pituitary gland, liver failure (this organ provides the utilization of hormones), certain gynecological or oncological diseases.
• Mastopathy. With such a common disease, discharge from the nipples can also be observed, but in most cases they are not purulent in nature.
• Ectasia of the milk ducts is their pathological expansion, most often developing in women over forty-five years old. With such a pathology, the resulting secret does not dissolve in the chest, as in the normal state of the ducts, but rushes along them to the tubules located in the nipples and goes out. In some cases, the deviation requires medical intervention.

Possible causes of purulent discharge

Suppuration of the nipples may be due to the following conditions, pathologies and diseases:

• Mastitis is an inflammatory disease. In most cases, it develops during the lactation period due to damage to the skin as a result of improper attachment or insufficient emptying of the breast. With such a disease, the discharge is accompanied by pain, hyperemia, severe swelling, bursting, an increase in the size of the mammary gland, as well as an increase in body temperature and clearly palpable lumps.
• Intraductal papillomas. These are neoplasms resembling warts, located on the walls of the ducts and, accordingly, deforming them. In some cases, with papillomas, purulent discharge from the nipples is observed. And when probing, seals can be detected.
• Malignant or benign neoplasms, especially those located inside the milk ducts and deforming them. Pus can be released with a significant size of the tumors, therefore, during examination, they will certainly be clearly palpable.
• Damage and further infection of the tissues of the nipple. This area can be damaged as a result of rough stimulation, invasive procedures (including piercing), non-compliance with pumping techniques (especially manual), and injuries.
• Cracks in the nipples occur when improperly applied during lactation and become a kind of entrance gate for various pathogenic microorganisms, such as streptococci, Pseudomonas aeruginosa, Staphylococcus aureus, enterobacteria. Their activity causes inflammation and, as a result, the release of pus.
• Mastopathy can lead to the formation of pus if the tissues that grow pathologically in the breast irritate and deform the milk ducts, damaging their walls. With this disease, a number of other symptoms are observed: engorgement of the mammary glands, seals in them, discomfort, changes in shape and size, soreness.
• Recent breast surgery. If tissue infection occurs during or after them, this can provoke suppuration.
• Furuncles or carbuncles. If they are located on the nipples, which, although rare, happens, then pus from the cavity can exit through the lactiferous tubules if it does not find another way out. Such neoplasms look like red abscesses rising above the skin, very painful under mechanical influences.

What to do

If you notice the discharge of pus from the breast, then this is clearly an alarming sign that requires immediate medical attention. A specialist mammologist will conduct a thorough examination and prescribe a number of diagnostic procedures: ductography, X-ray, mammography, ultrasound, blood tests. Based on the results obtained, a diagnosis will be made.

Treatment depends on the causes of suppuration. To stop inflammation, antiseptics and anti-inflammatory drugs may be recommended. Antibiotics are prescribed for bacterial infections. Sometimes hormone therapy is required. And to open the abscesses and remove the neoplasms localized in the chest, surgical intervention will be required.

The discharge of pus from the nipples is an unpleasant symptom that should alert any woman who cares about her health and make her visit a doctor.

Finding discharge from the nipples, most women begin to panic, suspecting that they have a serious illness. In fact, in many cases, this phenomenon is not a symptom of pathology. The breast of a woman is a gland, that is, an organ capable of producing a secret. Therefore, there is no need to suffer from disturbing suspicions and think about a malignant tumor. Cancer with discharge from the chest is rarely diagnosed. But, on the other hand, it is also not worth completely ignoring the problem. When discharge appears, you need to contact a specialist who will examine you and, if necessary, prescribe additional diagnostics.

Lactation disorders are also caused by the inability of the mammary glands to perform the excretory function normally, and secretion pathologies. Typical lactation disorders include hypogalactia, agalactia, lactostasis and galactorrhea.

Hypogalactia is most common when the mother's breasts produce less milk than the baby needs. In many cases, the situation can be improved by following the feeding regimen recommended by doctors. The extreme form of lactation insufficiency is called agalactia. In this condition, breast milk is not produced at all, and the only way out is artificial feeding of the baby.

With lactostasis, milk stagnation occurs in one or more lobes of the gland, as a result of which a serious complication can develop - mastitis.

Galactorrhea is a lactational pathology that is not associated with motherhood and the need to feed the baby. Milk in this case is secreted under the influence of hormonally active formations in the pituitary gland or under the influence of any other reasons. Pathological discharge from the nipples can be considered those discharges that appear three years after the last pregnancy or occur in a woman who has never become pregnant. Also, the pathology is the discharge of cloudy, serous and bloody fluid from the nipples. Similar phenomena are noted much less frequently and usually speak of some kind of disease of the breast.

Physiological secretion from the nipples of the mammary gland

Physiological lactorrhoea can be for the following reasons:

During pregnancy;

After childbirth;

Within 2–3 years after the last pregnancy with any outcome in women who are not breastfeeding and have a biphasic ovulatory menstrual cycle;

In newborns within 12-14 days after birth, a sexual crisis occurs under the influence of estrogens and prolactin of the mother.

Classification of the causes of discharge from the nipples of the breast

Doctors are guided by this classification when making a diagnosis when pathological discharge from the nipples is detected.

Hyperprolactinemic hypogonadism (primary hyperprolactinemic hypogonadism).

pituitary adenomas:

Micro and macroprolactinomas;

Prolactinomas in combination with adenomas in other endocrine glands;

Prolactinomas in combination with the "empty Turkish saddle" syndrome.

Galactorrhea and / or hyperprolactinemic hypogonadism in combination with other hypothalamic-pituitary diseases or medical effects on the hypothalamic region.

Acromegaly.

Itsenko-Cushing's disease and Nelson's syndrome.

Hormonally inactive formations of the hypothalamic-pituitary region:

Pituitary adenomas ("pseudoprolactinomas");

Craniopharyngomas;

Chondromas, gliomas, meningiomas, angiomas in the area of ​​the Turkish saddle, etc.;

Dissemination of systemic diseases (sarcoidosis, xanthomatosis);

Lymphocytic hypophysitis of pregnant women;

Syndrome of "empty Turkish saddle";

Chronic intracranial hypertension;

Transection or rupture of the pituitary stalk;

Condition after proton therapy on the adenohypophyseal region.

Galactorrhea and/or hyperprolactinemic hypogonadism as a secondary syndrome in endocrine and somatic diseases, neurogenic disorders and drug exposure.

With lesions of the peripheral endocrine glands:

Primary hypothyroidism (VanWick-Ross-Hennes syndrome or VanWick-Grumbach syndrome);

Tumors that produce estrogen;

PCOS (polycystic ovary syndrome);

CAH (Congenital adrenal hyperplasia);

Addison's disease;

Diffuse toxic goiter (Zondek's syndrome).

Iatrogenic forms due to medication or the introduction of IUDs.

Neurogenic disorders, including anorexia nervosa.

Renal and liver failure.

Extrapituitary tumors producing prolactin (bronchogenic carcinoma, hypernephroma).

Dishormonal, dysplastic and neoplastic diseases of the mammary gland.

Mastopathy.

Ectasia of the ducts of the mammary glands.

Operations, including plastic, on the mammary gland and chest.

Intraductal papilloma.

Mammary cancer.

Mixed reasons.

Idiopathic galactorrhea.

Discharge from the nipples - the norm and pathology

Since the breast is a gland, discharge from it is considered normal when it is associated with feeding a child. A meager discharge that is not associated with lactation is also acceptable. Fluid may come out of both nipples or only one of them. In some cases, the discharge occurs on its own, and in others - after pressure on the nipple.

The consistency of the discharge varies - it can be both thick and completely liquid. The color scheme is also varied - there are colorless, milky, yellow, greenish and in some cases even spotting.

As the first clear sign of hyperprolactinemia, abnormal discharge is infrequent - in only 20% of cases. And even more rarely, they are the main complaint of patients at the appointment of a gynecologist, endocrinologist or therapist. An exception can be considered only functional (idiopathic) lactorrhoea. In more than 70% of these patients, discharge is the leading symptom of the disease.

In all other cases, women have other symptoms that bother them in the first place. We are talking about violations of the menstrual cycle and generative function, overweight, headaches, etc. That is, nonspecific symptoms come to the fore. Lactorrhea in such cases is often detected by the doctor, after listening to the patient's complaints and carefully examining her.

What discharge from the nipples can be

If there is a discharge from the nipples, you need to pay attention to their volume, smell and color. These signs will help draw conclusions about the alleged pathology, which may need to be treated in order to prevent the development of serious complications.

White discharge is milk and is normally observed during the feeding period. If milk production is not associated with lactation, we can talk about galactorrhea (when discharge from the nipples appears due to the high content of prolactin in the female body, the hormone responsible for milk production).

Yellow discharge from the chest is also considered a manifestation of galactorrhea. In this case, thyroid pathology, problems with the pituitary gland, impaired renal or liver function can be suspected. Also, yellow discharge can occur after long courses of hormone therapy.

Brown discharge from nipples

The brown hue of discharge from the nipples is due to chest injuries, as well as damage to blood vessels and milk canals. Such damage often occurs due to tumors, primarily breast cysts. With cysts, the discharge is usually brownish with a gray or green tint.

The appearance of blood in the discharge from the nipples is an alarming sign. It may be evidence of a malignant process.

But you don’t need to panic right away - it is quite possible that the discharge with blood from the nipples is caused by intraductal papilloma. (This formation, however, can eventually turn into an oncological disease, so it cannot be ignored).

The discharge of clear fluid from the nipples is usually physiological and observed in stressful situations, may be associated with stimulation or the menstrual cycle. Normally, there are very few such secretions, they do not have any smell and are not accompanied by unpleasant sensations.

Green nipple discharge

Green color indicates the presence of a certain amount of pus in the discharge. Also in this case, the discharge may have a yellowish or gray tint. Similar signs are characteristic of mastopathy, which is a dishormonal disorder with the formation of seals and pain in the chest.

Discharge from nipples with pus

Purulent discharge from the nipples of the mammary gland is a sign of an inflammatory disease of the mammary gland. So, purulent abscess formation leads to infection in the ducts during feeding. At the same time, the chest becomes painful, the areola turns red, and there is pronounced swelling.

Gray nipple discharge

A gray tint in some cases indicates an increased level of prolactin in a woman's body. Such discharge may appear during pregnancy, as a result of a long course of hormonal drugs or after a long intake of contraceptives.

Sticky discharge from nipples

If there is a sticky discharge from the chest, blockage or deformation of the subalveolar ducts can be suspected. The shade of discharge in such cases is different. Often there are additional symptoms - retraction of the nipple and thickening of the tissues around it.

Discharge from the nipples smells strongly

If the discharge from the nipples has an odor, then there is an inflammatory process in the purulent stage. Pathogenic microorganisms secrete waste products that have a pronounced odor. With discharge with pus, this smell is felt especially strongly. In such cases, discharge is not the only sign of the disease. With the inflammatory process in the chest, pain is felt, it turns red, swelling occurs.

Discharge from black nipples

The appearance of black discharge from the nipples is a clear sign of the presence of blood. Such a secret is characteristic of tumor processes. In such cases, the blood turns black due to the fact that the affected area is located deep in the tissues of the breast, and not near its surface.

Dry discharge from nipples

Dry discharge from the nipples is a phenomenon often observed with ectasia of the mammary glands. In this case, viscous thick secretions are collected in the lumen of the lactiferous duct, from which a secret of a dense consistency is formed. Such secretions can be of different shades and differ in smell.

Curdled discharge from the nipples

Discharge from the nipples of a curdled consistency may indicate a fungal infection of the milk ducts, this can happen when breastfeeding, when there are cracks and abrasions on the skin of the nipples. Curdled discharge usually has a sour smell. A woman feels discomfort in her chest, she may itch and itch.

Discharge from the nipples before the onset of menstruation

If the appearance of discharge is associated with the menstrual cycle (the secret is released before or during menstruation), then there may be a serious hormonal disorder. First of all, it concerns the level of the hormone prolactin, which is responsible for lactation. The hormonal background can change under the influence of various factors, but in most cases this is facilitated by the long-term use of contraceptives.

The discharge associated with the menstrual cycle is most often scanty, clear, or with a white and yellow tint. To identify the cause of such discharge, the patient is usually referred for a blood test to assess the level of prolactin.

There are cases when a woman who has given birth a few years later still has a little milk before menstruation. This phenomenon is also associated with elevated prolactin levels. The fact is that in some women it decreases more slowly than others.

Discharge from the nipples during pregnancy

During pregnancy, lactation, and for some period after weaning, the mother may experience discharge, which is a clear secret or colostrum. Such discharge is considered normal and indicates increased sensitivity of the nipples.

Discharge from the nipples while taking medication

Pathological discharge from the mammary glands can occur when taking certain medications. The list of medicines is given in the table.

Pathological discharge from the nipples

Unfortunately, in some cases, discharge from the mammary glands can indicate pathological conditions and the development of serious diseases. Let's talk in more detail about the main problems accompanied by discharge from the nipples.

ectasia

With this disease, the milk canal becomes inflamed, and a thick liquid accumulates in its cavity, which usually has a green tint. Sometimes it is also dark, almost black. Such discharge is more often observed in patients aged 40 to 50 years.

In order to alleviate the course of this disease, women are advised to apply warm compresses to their breasts. With severe pain, the doctor may prescribe a course of anti-inflammatory drugs. Antibiotics are indicated only in the case of an inflammatory process, and it is highly undesirable to take them without consulting a specialist. In the case of a severe course of ectasia, one has to resort to a radical method - a surgical operation to remove the diseased duct of the mammary gland.

Intraductal papilloma

This pathology is a small benign formation that has formed in the cavity of the milk duct. At the moment, the reasons for the occurrence of such formations have not been fully elucidated. It is also not known how high the probability of their degeneration into a malignant tumor is. A typical sign of intraductal papilloma is discharge with bloody impurities. Moreover, in many cases they are independent (without squeezing the nipple) and their traces can be seen on the inside of the linen. At the same time, you can feel a slight seal in the nipple area. Such neoplasms are usually found in women from 35 to 55 years.

If papilloma is suspected, the patient is shown an ultrasound examination of the breast, as well as an x-ray of the ducts with contrast. Discharge from the nipples is sent for laboratory analysis.

Galactorrhea

In this condition, a colostral, brownish or yellow secret is secreted from the woman's breast. Most often, galactorrhea is explained by an increased level in the body of a woman of prolactin, a hormone that is responsible for the production of breast milk in the mammary glands. Sometimes other factors also lead to galactorrhea: prolactinoma (a specific neoplasm of the pituitary gland), thyroid disease, hormonal disorders associated with prolonged use of contraceptives. Also, galactorrhea can be caused by overstimulation of the nipples.

chest injury

With traumatic injuries of the mammary glands, completely transparent discharges may appear, or discharges mixed with blood.

Mastitis

This inflammatory disease is familiar to many women. In the people it is still often referred to as "breast". With the development of this disease, purulent discharges are often observed (since mastitis involves the formation of an abscess in the tissues of the gland - an inflammatory focus in which pus accumulates).

Mastopathy

Fibrocystic disease is one of the most common breast pathologies. It develops with hormonal disorders and is manifested by a violation of the ratio of fibrous and cystic tissues. One of the signs of this disease is discharge from the nipples.

Malignant tumors

Unfortunately, in some cases, pathological discharge and nipples may indicate the development of an oncological process (breast cancer). In such cases, an intraductal tumor or invasive cancer is usually suspected. One form of breast cancer is Paget's disease, which is a malignant tumor of the nipples. This is a rather rare pathology, it accounts for no more than 4% of all cases of breast cancer. It is manifested by bloody discharge, severe itching in the nipple area and external changes (nipple configuration, areola color). If suspicious symptoms appear, it is necessary to urgently contact a medical institution in order to prevent the transition of the disease to an advanced stage. With timely treatment, an organ-preserving operation is possible, that is, only that part of the mammary gland where the tumor is localized is removed.

Diagnostic methods for discharge from the nipples

Collection of anamnesis

Pathological discharge from the nipple can be based on a variety of factors, which creates certain diagnostic difficulties. Therefore, it is impossible to find out the nature of the pathology without a thorough history taking.

First of all, it is necessary to find out all the circumstances of the patient's life that may be associated with the appearance of discharge. Common influencing factors include: pregnancy (also interrupted), childbirth, lactation, long-term stressful situations (especially during puberty of a girl), traumatic injuries of the chest and chest, craniocerebral injuries. It is also necessary to find out what drugs the patient has taken or is taking. This is a very important point when taking an anamnesis, since lactorrhoea can have a pharmacological origin.

Physical examination

At the very beginning, it is necessary to carefully examine the patient for signs of endocrine and somatic pathologies that could lead to the development of galactorrhea. After the examination, they proceed directly to the examination of the mammary glands.

When studying the condition of the skin, special attention should be paid to changes in turgor, humidity, and skin tone (these signs may indicate a violation of the thyroid gland). The presence of age spots, striae and scars may indicate hypothalamic syndrome, Itsenko-Cushing's disease, Addison's disease. The severity of the hairline and the features of its distribution are important (with PCOS or CAH, hirsutism is observed). In addition, it is necessary to make sure that there are no characteristic rashes, because lactorrhoea may be associated with herpes zoster.

The patient's breasts are examined in two positions - sitting and lying down. Moreover, in the supine position, the patient must first stretch her arms, and then lower them. Palpation of the breast should be performed smoothly, with sliding movements from the periphery towards the areola. Then decanting is done from the edges to the center of the areola in order to obtain a discharge. If milk or a colostrum-like secret comes out during decanting movements, we can talk about lactorrhoea. This phenomenon is bilateral in nature, and the degree of its severity is determined according to the following scale:

- intermittent lactorrhea (+-);
- after strong pressure, single drops are observed (+);
- after gentle pressure, abundant drops or a jet appear (++);
- there are spontaneous discharges (+++).

Discharge volume alone is not a valuable diagnostic criterion and can vary greatly. Much more important in the examination is a visual assessment of the discharge, which is usually performed using a magnifying glass. It allows you to distinguish lactorrhea from other pathological secretions.

True purulent discharge is not typical, although such discharge is sometimes noted near the edge of the areola. There may be a drainage hole of the abscess, which arose after the cyst festered.

Serous bloody or bloody discharge from one nipple, appearing drop by drop, indicates the presence of intraductal papilloma.

Isolation of a clear or greenish secret from both nipples is a sign of fibrocystic mastopathy. Other symptoms of this common pathology are the presence of tender or painful lumps.

Quite often, when you press the nipple, a completely transparent serous fluid appears in a small amount. This phenomenon should not be alarming, since it has no special diagnostic value and is the norm for women who have given birth.

This is followed by another mandatory stage of the examination of the patient - a two-handed vaginal examination. With PCOS (polycystic ovary syndrome) and primary hyperprolactinemic hypogonadism, there is a decrease in the uterus. PCOS is also characterized by enlargement of the ovaries.

If a volumetric process in the pituitary gland is suspected, it is necessary to examine the visual fields. In patients with macroprolactinoma, the epicenter of the lesion is located in the region of the crossing fibers of the optic nerves. In some cases, this can lead to chiasmal syndrome (bitemporal hemianopsia), which is manifested by loss of visual fields, first in the upper temporal and then in the lower temporal quadrants.

Methods of laboratory diagnostics

Patients with pathological lactation are necessarily sent for the study of the level of the hormone prolactin. The results of such diagnostics are of great diagnostic value. In the plasma of healthy women, the content of prolactin varies over a fairly wide range (2-16 µg/l). The average value of this indicator is 8.0+-4.95 µg/l. The level of prolactin depends on the time of day. During sleep, its secretion increases, and in the morning upon awakening it sharply decreases. The minimum concentration of prolactin is observed in the late morning - between 9 and 11 hours.

A simultaneous increase in the secretion of cortisol and prolactin occurs after a daily intake of a conventional mixed meal (midday 12-13 hours). Protein foods are known to increase both prolactin and cortisol, and fatty foods stimulate prolactin production.

There are other physiological conditions in which the production of prolactin increases. So, the level of prolactin is increased in the second phase of the cycle, as well as during sexual intercourse (it rises especially strongly during orgasm). Stress and physical activity also increase the secretion of this hormone. In addition, prolactin increases during pregnancy and in the postpartum period. During the examination of the patient, it is necessary to take into account all these factors in order not to distort the results and not make incorrect diagnostic conclusions.

Depending on the clinical form of lactorrhoea, the level of prolactin varies within a fairly wide range. Its maximum values ​​can exceed 100 µg/l, which is typical for tumor formations in the pituitary gland. A moderate increase - 50 mcg / l - speaks of idiopathic galactorrhea, mixed lactation disorders, as well as the syndrome of an empty Turkish saddle.

There is also a normoprolactinemic variant of galactorrhea. It is diagnosed in healthy women when the lactation period is prolonged, and in patients with erased forms of endocrinopathies and some mental or somatic diseases.
At the moment, several molecular forms of this hormone have been described:
monomeric or native. It is characterized by high receptor-binding and biological activity. Molecular weight - 22 kDa.

Big prolactin and big-big prolactin (big and bigbig). The molecular weight is 50 and 100 kDa, respectively. They are aggregates of native prolactin, have high immunoreactivity, and are characterized by moderate biological activity. Affinity for specific receptors is low. Conditions in which regular menstruation and normal fertility are combined with a significant increase in prolactin are now explained by "big" and "big-big" prolactinemia.

Glycosylated prolactin. Its immunoreactivity is less than that of monomeric prolactin. The molecular weight is approximately 25 kDa.

prolactin-like peptides. Their role in the body has not yet been fully elucidated. Molecular weight - 8 and 16 kDa.

If a woman has hyperprolactinemia against the background of a normal cycle and in the absence of galactorrhea, there is reason to suspect "big" and "big-big" prolactinemia. To determine it, the gel filtration method is used.

In addition to the analysis for the level of prolactin, other laboratory tests are also performed. So, it is necessary to determine the level of TSH, since in the initial stages of prolactinoma and hypothyroidism are almost indistinguishable.

Analyzes to determine the level of LH and FSH, progesterone, estradiol, testosterone, growth hormone, DHEAS are performed only when there are suspicions of endocrinological pathology.

Instrumental Methods

Using such highly informative methods as CT and MRI, it is possible to identify intracranial defects, small neoplasms (less than 5 mm) and assess how much the process has spread beyond the Turkish saddle. Also, these methods allow us to confirm a rather rare diagnosis called "syndrome of an empty Turkish saddle."

Modern endoscopic technologies open up opportunities for early detection of pituitary microadenomas. But to date, such methods have not yet become widespread. With their help, you can examine the pituitary fossa in detail (in this case, a transsphenoidal approach is used), identify even the smallest tumors and defects. If necessary, a sample can be taken during endoscopy for morphological examination.
If the presence of a pituitary tumor or secondary hyperprolactinemic hypogonadism cannot be confirmed, the patient is diagnosed with idiopathic lactorrhoea.

Methods of treatment for pathological discharge from the nipple

Therapy for pathological discharge from the nipples depends on the cause that caused them. To find out the nature of the disease, it is necessary to consult a mammologist and undergo all the prescribed examinations.

It is quite possible that a correction of the hormonal background will be required, then the patient can be referred to an endocrinologist. The doctor may recommend a course of drugs - DA agonists (Parlodel and Bromkriptin). These drugs have the ability to slow down the production of prolactin. Take them at a dosage of 2.5 - 3.75 mg per day. If necessary, the doctor can double the dosage. The course of admission is continued until the hormonal background is normalized.

It is undesirable to resort to folk methods without the consent of a doctor. After all, it is impossible to cure a disease without knowing its causes. Self-medication can only aggravate the situation. Therefore, if any suspicious symptoms appear, you should immediately contact a medical institution, undergo the necessary diagnostics and wait for a diagnosis. And only then, having received the consent of the doctor, can folk recipes based on medicinal plants be used for treatment.

The appearance of discharge from the nipples is one of the main complaints with which patients turn to a mammologist. Fluid from the breast may flow spontaneously or appear only at the moment of squeezing the nipple.

The color of the discharge from the nipples can be different: white, yellow, gray, bloody. According to their consistency, they are watery, liquid or thick.

And if the discharge of a whitish liquid (colostrum) from the nipples during pregnancy is the norm, then in all other cases, any discharge from the chest is, most often, a symptom of certain diseases of the mammary glands.

Causes of discharge from the nipples:

• Ectasia (dilation) of the milk ducts. An inflammatory process occurs in several or one milk duct, as a result of which exudate begins to accumulate in it. The disease usually occurs in women over the age of 40. Its first sign is the appearance of discharge from the nipples of a dark or green color. Treatment is usually conservative, but sometimes surgery may be required to remove the affected duct.
• White discharge from the nipples is most often observed with galactorrhea and is a milky liquid, colostrum or milk. Similar discharge from the nipples during pregnancy, as we said above, is the norm. In all other cases, they are a symptom of a hormonal imbalance in a woman's body. Therefore, if you have white discharge from the nipples, then you should definitely visit a mammologist and an endocrinologist. You should also donate blood for the content of prolactin and thyroid hormones. Sometimes galactorrhea can occur in women taking oral contraceptives.
• The appearance of transparent yellow or green discharge from the nipples can be observed with a fibrocystic form of mastopathy.
• Closed chest injury. In this case, bloody discharge from the nipples is observed. In some patients, they are not bloody, but yellow.
• Transparent discharge from the nipples can appear against the background of acute or exacerbation of chronic diseases of the female genital organs, as well as after an early miscarriage or induced abortion.
• Mastitis. With purulent fusion of breast tissue, purulent discharge appears from the nipples. In this case, the treatment is carried out by the surgeon and consists in opening the abscess, draining its cavity and prescribing antibiotics.
• Intraductal papilloma. It is a benign tumor located inside the cavity of the lactiferous duct. One of the symptoms of this disease is the appearance of bloody discharge from the nipples, which have a fairly thick consistency. Surgical treatment with obligatory histological examination of the removed breast tissue.
• Mammary cancer. The disease is asymptomatic for a long time. One of its first signs is the appearance of bloody discharge from the nipple from the affected breast. Often, at the same time, a woman notes an increase in the same breast and the appearance of a nodular neoplasm in its thickness. Some patients complain that they have sore nipples and spontaneous discharge from the chest.
• Paget's disease. This disease is a special form of breast cancer that primarily affects the nipple. With Paget's disease, the appearance of the nipple changes (drawing in, deformation), its color (darkening or redness). Often, patients complain that they have discharge and the nipple hurts, or itching, burning occurs in its area. The treatment for Paget's cancer is surgical removal of the breast (mastectomy).

Discharge from the nipples: what to do?

If you find yourself with discharge from the nipples, you should definitely come to an appointment with a mammologist. To make an accurate diagnosis, laboratory and instrumental examinations are required:

• Ultrasound examination (ultrasound) of the mammary glands;
• Mammography;
• Blood test for hormones;
• Cytological examination of discharge from the nipples.

Remember that the appearance of any discharge from the mammary glands always requires special attention and a mandatory in-depth examination. This is especially true of bloody discharge from the nipple, the appearance of which should immediately consult a doctor!

Video from YouTube on the topic of the article:

Discharge from the nipples- liquid of any color that is secreted from the nipples of a non-breastfeeding woman. It flows from the ducts from which breastfeeding mothers normally flow milk. Sometimes there is a unilateral, and sometimes bilateral flow.

Discharge classification

Discharge from the nipple can appear on its own, or when a girl / woman presses on her breasts. Color highlights:

• brownish
• yellowish
• dairy
• transparent
• greenish
• color changing
• with blood, etc.

When you see a doctor, you will also need to describe the consistency of the discharge. She may be:

• liquid
• slightly thick
• very thick

The older the woman, the higher her risk of nipple discharge. Also, this problem is typical for those who are preparing to give birth, or have already given birth to a child.

Norm and pathology

Transparent highlights small amounts are the norm. This does not mean that you will have nipple leaks every day. But this can happen if you have injured the mammary gland (one or two). This can happen when:

• blows
• falls
• prolonged compression, etc.

White highlights can talk about the diagnosis of galactorrhea. This is a pathology that arises from an excess of a hormone called prolactin. Its role is for a woman to produce milk. If the discharge does not begin in those who are expecting a baby, or who are breastfeeding an already born baby (before and after the end of breastfeeding), then this indicates the need for accurate diagnosis and immediate treatment.

White discharge from the nipples may indicate that one of your organs is not working well enough. This may be kidney failure, liver failure, hypothyroidism, pituitary tumor, ovarian pathology. Possible causes of discharge from the nipples will be discussed below.

Discharge from nipples that changes color, may also be with galactorrhea. They can be white, and then stand out greenish, with a yellow tint or transparent. A possible diagnosis may be fibrocystic. If you have noted purulent discharge in yourself, this is a signal of an infection. So, you need very urgently qualified treatment. With the help of a doctor, you need to determine the pathogen, and this will help you choose the right methods of treatment and the right, effective medicines.

The reasons

As already noted, there is far from one reason for discharge from the nipples. Let's take a closer look at the most common options below.

• ectasia (dilation) of the milk ducts

This reason is often found when patients complain of discharge from the nipples (breast). An inflammatory process occurs in the left or right (and sometimes in two at once) duct. A discharge of a greenish or black tint is collected in the duct. They are thick and sticky. Basically, this diagnosis is made by ladies aged 40 and 50 years, but options are possible.

This is a discharge from the mammary glands of a girl or woman. milk, milky liquid or colostrum. The reason is that the level of prolactin in the body has become higher. The reason may be changes in the level of other hormones if you used oral contraceptives. Some women develop pituitary tumors called prolactinomas. Another option is poor thyroid function.

• mastopathy

With this disease, you may notice that discharge from the nipples:

• green
• transparent or
• yellow

The causes of this pathology may be different, but the pathogenesis is the same. First, an inflammatory process develops, which causes swelling. Edema, in turn, contributes to the occurrence of fibrosis, and then cystic degeneration begins. Treatment aims to interrupt this process and prevent its development in the future.

• diseases of the organs located in the small pelvis of a woman

Doctors refer to these organs as the uterus and its appendages. Also in this group of causes include miscarriages and abortions. The discharge may be more or less abundant, depending on the period at which the pregnancy was terminated. If you have an abortion in the early stages, then cardinal changes will not occur in the body yet, and therefore there will be no discharge (or there will be a small amount). Bleeding lasts an average of 48 hours, and then less and less is allocated until it stops completely.

• closed chest injury

If the cause is in it, discharge from the nipples can be:

• yellowish
• transparent
• with blood

Discharge from the nipples after an injury cannot be treated on its own. Several pathological processes can begin to develop simultaneously in the chest, the treatment of which, if you start the situation, will be extremely difficult and dangerous.

• purulent diseases of the mammary glands

If this is the reason, you will need the help of a surgeon and treatment with antibacterial drugs aimed at a specific pathogen, or with a wide spectrum of action.

The sooner you see a doctor about this problem, the easier the treatment will be. Conservative methods are applied in the early stages of this acute inflammatory disease. But, if you "launched" the disease, you will have to do an operation, which is more dangerous.

• papilloma inside the milk ducts

One of the manifestations of this disease is bloody and thick discharge from the nipples. In all cases, surgical methods of treatment are resorted to. Then the papilloma, which was removed, is taken for histology. There, the doctor determines whether it is malignant or benign, which will affect further treatment.

• (malignant formation)

You may not know about this disease for the time being, because there may not be any symptoms. If from one nipple you have liquid with blood from time to time, and at the same time the breast has become larger (or you have felt nodules in it), you need to urgently run to the doctor. But this is not such a frequent situation, therefore, with discharge from the nipples, you do not need to make the most sad predictions on your own.

This is a specific form of breast cancer. This tumor-like formation concerns the nipple. In this area, unpleasant sensations appear, such as itching or burning. The areola of the nipple becomes dark or reddens, and the skin there is flaky. One of the symptoms: discharge with blood from the nipple

Diagnostics

If you notice discharge from the nipple for at least two days, you need to urgently go for an in-person consultation with a mammologist. She is a female breast specialist. You cannot determine the cause on your own, because there are a large number of them. And only a few of them have been described above. The doctor must palpate the affected and visually healthy breast. Visual inspection data are also important. If there is a discharge, the doctor also notes for himself their consistency, color and quantity.

But this is only the initial stage of diagnostics, which determines the further strategy. You will be given ultrasound diagnostics (ultrasound) of one or two mammary glands, and a mammography examination will be prescribed. Most often, patients donate blood to the level of hormones. Other studies may be ordered if the doctor deems it necessary. In no case do not consider them redundant. The results of the research help to distinguish among themselves very dangerous diseases that cannot be diagnosed by ordinary palpation.

Sometimes mammologists send the patient to doctors of a different profile, because discharge from the nipples can speak not only about breast pathologies. Consultation with an ophthalmologist and an MRI are indicated if a pituitary tumor is suspected.

Prevention

It is better to carry out the prevention of breast pathologies than to treat the discharge from the nipples and their cause later. Prevention measures are very simple, and women and girls of all ages should know about them.

Feel your breasts every day, or at least every week. If nodules or other incomprehensible formations appear there, it is worth contacting a mammologist or gynecologist for an in-person consultation.

Rule number 2: never cool and protect your chest from injury. This also applies to being in a wet swimsuit. Choose bodices that dry quickly. If you prefer push-up swimsuits that keep your chest moist for a long time after swimming, then wear something dry when you get out of the water after swimming. This will help to avoid inflammation in the mammary gland.

If you have disturbing symptoms, do not look for solutions on the Internet, immediately make an appointment with a doctor.

Treatment

Treatment can be different, and it depends on the causes. These may be the following methods:

• antibiotics
• hormonal preparations
• folk methods of treatment
• surgical intervention

Do not ignore such an alarming symptom as. It could even be cancer! And it is important to diagnose any oncology in time, because the days count. But cases of breast cancer are not very common. So don't get upset ahead of time.

It is important to maintain breast hygiene. At least 2 times a day, the breasts should be rinsed under a warm shower and immediately dried with a towel to ensure dryness. Choose soft bras that do not cause compression of the breast and allow free access of blood to the mammary glands.

Sometimes, if mastopathy is the cause of discharge from the nipples, a drug such as is prescribed. It eliminates the causes of disease and stops painful changes in the chest. The action of the drug is based on the fact that it relieves swelling, inflammation, etc. It can be combined with other medicines for mastopathy.

Remember that with any disease, early diagnosis guarantees easier treatment. If you notice discharge from your nipples, consult a doctor, and do not sit on the forums!