Medicines for Nipple discharge

What it is

Nipple discharge is fluid leaking from the nipple. It is a common symptom and often has a harmless cause. Discharge from both nipples, that only appears when squeezed, and that is milky, green, yellow or clear, is frequently benign — for example related to normal hormonal changes, breast cysts, or non-cancerous duct changes; a milky discharge can also relate to breastfeeding, some medicines, or raised levels of a hormone (prolactin). However, certain features make it more important to check: discharge from only one nipple, from a single duct, that is bloodstained or clear and watery, that occurs on its own (without squeezing), or that comes with a lump or other breast changes. While most nipple discharge is not due to cancer, these features can occasionally point to an underlying problem, so any nipple discharge — particularly with these features — should be assessed. Discharge during pregnancy and breastfeeding is normal.

How it is treated

Assessment aims to find the cause and exclude anything serious. A doctor will ask about the discharge (which nipple, colour, whether spontaneous or only on squeezing, one duct or many) and other symptoms, examine the breasts, and, depending on the features and the person's age, may arrange further assessment — such as imaging (ultrasound and/or mammogram), blood tests (for example checking prolactin and thyroid if a milky discharge suggests a hormonal cause), and, where indicated, tests of the discharge or the affected duct. Treatment depends on the cause: many benign causes need only reassurance or simple management; a hormonal cause (raised prolactin) is investigated and treated; a troublesome benign duct problem may be treated; and anything more serious is managed appropriately. The reassuring message is that most nipple discharge is not due to cancer, but it should be checked — especially if it is one-sided, bloodstained, spontaneous, or comes with a lump.