CAUSE
The cause could be:

• Breast abscess (most common in lactating women)
• Injury to the breast
• Drugs (eg cimetidine, methyldopa, metoclopramide, oral contraceptives, phenothiazines, reserpine, tricyclic antidepressants, or verapamil)
• Prolaktioma (tumors in the brain that produce prolactin). Prolactin is a hormone produced by the pituitary gland, which triggers the growth of the mammary gland and milk formation.
• Intraductal papillomas (benign tumors that grow in the breast line)
• Duct ectasia (widening and hardening of the breast line due to aging and damage).

Nipple discharge is not due to malignancy, almost half are caused by the papilloma and the rest are caused by changes fibrokista or duct ectasia. Nipple discharge which is a malignancy is only about 10% and almost always unilateral.

SYMPTOMS
Liquids such as milk (cloudy, whitish, thin and not sticky) is the most frequent type of fluid found and mostly caused by lactation (milk formation) or the increasing excitation mechanism due to touch your nipples, suction or irritation of clothing during exercise or other activities.

If the fluid contains blood or watery (serous) cause is a papilloma or infection.

Usually a clear liquid, like milk, yellow or green, and out of both nipples, not a sign of breast cancer. Fluids that contain blood or diluted, especially if only out of one nipple, an abnormal fluid, but only about 10% of abnormal fluid which are malignant.

Fluid from the nipple needs special attention if:

• Dilute or reddish color with red, pink or brown
• Sticky and clear or brown color to black (glossy)
• Out spontaneously without having to rub your nipples
• Sedentary nature
• Just out of one nipple (unilateral)
• Fluids other than breast milk.

Diagnosis Diagnostic tests for nipple discharge include:

• Breast biopsy (if a lump is found)
• Fluid cytology
• CT scan of the head (to look for pituitary tumor)
• Mammography
• Serum prolactin levels
• Transillumination
• Breast ultrasound
• Galaktogram or duktogram (to help find intraductal papillomas).

Treatment

The standard treatment for nipple discharge that is not influenced by the hormone is the cutting line. Channel cutting is usually done with local anesthesia and the procedure is performed through small incisions in the areola (brown area surrounding the nipple).

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