There were discharges from the mammary glands with pressure. What does discharge from the nipples indicate?

The female body is a complex system, whose functioning can easily ask a question that is difficult to give an unambiguously correct answer. One of the most poorly understood pathologies in women is discharge from the chest with pressure.

About what problems may arise in connection with this, the website Koshechka.ru will tell.

Causes of discharge from the chest

First of all, I want to reassure women who are in the lactation period - discharge from the chest with pressure is a completely normal phenomenon both during pregnancy and, of course, during the feeding period.

Discharge from the chest in a pregnant woman or a woman who has recently given birth is a natural phenomenon

In some, the discharge begins only after childbirth, during the period of active feeding, but more often - in the fifth or sixth month of pregnancy, and the color of the liquid varies from yellow to white, and the consistency is from thick to watery. One-time appearances are also considered the norm during this period. spotting from the chest, however, if these do not stop for a long time, you should consult a doctor.

If you have not yet become a mother or have experienced breastfeeding for a long time, listen to your body - the appearance of secretions of various consistency indicates a deviation from the normal functioning of the body.

In the ducts located in the mammary glands, there is always a little fluid, which sometimes comes out in the form of transparent secretions, especially when the chest is pressed. However, if the amount allocated has increased significantly, pay special attention to this. The reasons for the increase in the volume of fluid released can be:

taking potent medications - antidepressants or hormonal drugs;
violations hormonal background;
nervous and physical overstrain;
the impact of great force on the chest - blows, bruises, in rare cases - mammography;
wearing inappropriate (tight) underwear.

A one-time allocation of a secret is not a big deal. It may have an unpleasant odor, a cloudy, mucus-like consistency, and a greenish-yellowish color. With the repetition of discharge, we can talk about significant deviations in the state of the female body.

A more accurate cause can be suggested by the doctor during a full examination and testing.

Discharge from the chest with pressure: a disease or a norm?

The most common types of discharge from the chest are:

White discharge from the chest. If, when pressed, a milky, yellow or brownish liquid is released in relatively small quantities, then it's okay - this is considered quite normal. However, if such discharge began in a non-lactating, non-pregnant woman, or more than five months have passed since the lactation period, this indicates the appearance of a disease such as galactorrhea. It is caused by an excess of prolactin in the body, the hormone responsible for milk production.

To some of possible causes the appearance of white discharge from the chest when pressed may include injuries and disorders of the hypothalamus, injuries of the nipples and milk canals, pituitary tumors, kidney failure, ovarian diseases, and much more.

Whitish creamy thick discharge from the chest when pressed, if it occurs in small amounts, can be caused by reasons such as the use of a condom during intercourse.
Bloody issues. Such discharge can appear both independently and after pressing directly on the nipple or mammary gland. Bloody discharge may indicate a chest injury or the occurrence of an intraductal papilloma, a benign tumor that requires immediate diagnosis and treatment.
Purulent discharge. They occur with advanced forms of a disease such as an abscess.
brown discharge from the chest, manifested by pressure, may be signs of diseases caused by infections. If blood particles are also present in this fluid, then the disease has been started.
Clear discharge from the chest, coming out with pressure in large volumes of discharge may be the result of trauma to the chest or a tumor of the mammary gland.

The site site warns: the above classification and symptoms are only approximate, the most common. However, there are many exceptions that require diagnosis. So, for example, discharge from the chest that occurs in women of postmenopausal age (50-55 years) indicates possible pathological abnormalities. Sometimes the appearance various kinds discharge only heralds the onset of menopause.

It is worth noting that any discharge from the chest, which is a deviation from the norm, requires immediate identification of the causes of their occurrence. To maintain your own health, do not forget about prevention:

at least twice a year to be examined by a gynecologist;
after 40 years, do a mammogram (in a year);
do not forget to regularly independently palpate the chest for seals and inflammation;
if discharge occurs, do not postpone a visit to the doctor.

Every woman should think about her own health and not start diseases in the female part, because timely treatment started is the key to a quick recovery.

Ivanova Alexandra - especially for Koshechka.ru - a site for lovers ... into yourself!

There are many reasons why a woman may go to a breast specialist, the most common being discharge from mammary glands. This can instill fear, not always a symptom indicates some kind of serious illness. The appearance of a few drops of liquid indicates the production of a secret in the mammary gland, or be a symptom of a serious illness. Spontaneous protrusion of fluid is possible, with pressure on the chest. May occur from both breasts at the same time.

Allocations that are the norm

Discharge from the breasts during pregnancy is normal. They are transparent, yellowish in color, protrude when pressure is applied to the nipple. Often begins in the fourth month of pregnancy. In the first trimester, discharge with streaks of blood is possible. The reason may be the hormones necessary for lactation, it is considered the norm, but a doctor's consultation is desirable.

After childbirth, milk begins to be produced. It continues to stand out throughout the feeding period, for some time after completion, ends on its own. Remaining secretions after cessation breastfeeding a few months is normal. May appear after abortions, miscarriages. This happens due to hormonal changes, after the normalization of the hormonal background, they disappear.

The appearance of fluid in a woman is possible with the use of hormonal drugs, after rubbing with a tight bra, during physical activity including chest tension. They may contain streaks of blood, an unpleasant odor, a strange color, this may indicate pathology. This is accompanied by visual changes in the breast, a woman's poor health.

What problems can be

In order to find out what nature the problem is, you need to evaluate the color of the substance released. They can be of the following shades:

Having no highlight color is a good sign that there is no problem. The reasons may be stress, premenstrual phenomenon, breast trauma. If no other symptoms are found, in many cases no pathologies are found. The presence of pain, thickening, not a pleasant smell, this may mean that a detailed diagnosis is necessary.
A brown liquid that is released may appear if the vessels are damaged. It may indicate oncology, be one of its symptoms, or benign mastopathy.
Blood-colored discharge is a dangerous sign, it can indicate the formation of a possible malignant nature. There may be papillomas, with them a bloody discharge is possible. If these symptoms are present, an urgent visit to the doctor is necessary.
A green tint indicates mastopathy. You need to examine the breasts for seals, take tests for hormones, for an accurate diagnosis.
Yellow discharge - considered the norm, indicates the onset of pregnancy. This is due to the hormone prolactin in the woman's blood.
White discharge indicates galactorrhea. Possible problems with the thyroid gland, pituitary gland.

The main causes of discharge

In many cases, the appearance of discharge from the chest indicates the presence of a pathological disease. The probable causes of fluid secretions can be diseases:

Ecstasy of the milk ducts is characterized by inflammation of the excretory tract, exudate may begin. The very first symptom may be the appearance of discharge from the nipple gray, greenish shades. It occurs when pressed, on its own. The disease is observed in women after 35 years. For treatment, compresses are applied to the chest. To eliminate pain, you need to take an anti-inflammatory non-steroidal medicine. Treatment with antibiotics is necessary, if the case is rather complicated, surgery is required.
Mastitis is an acute infectious disease, observed during breastfeeding. Symptoms of the disease: swelling of the breast, sharp pain in the chest, modification of the skin of the mammary gland. The body temperature rises to 39 degrees, due to the accumulated pus, the discharge becomes green. Mastitis can occur if a woman does not pump properly, lactostasis develops further, its appearance is possible due to cracks in the nipples, and improper hygiene. If the condition worsens, it is necessary to stop breastfeeding, start the use of antibiotics, detoxification therapy. If an abscess is present, surgery is needed.
Galactorrhea is called spontaneity in the allocation of milk, colostrum in a woman who is not pregnant and not breastfeeding. Milk begins to be secreted when exposed to the hormone prolactin. Tumors of the pituitary gland, injuries, formations on the hypothalamus. Diseases thyroid gland, adrenal glands, ovaries, stress, renal and hepatic insufficiency. If the causes of milk discharge are not known, the diagnosis is idiopathic galactorrhea. The main signs are white discharge from the chest, menstruation is disturbed, body hair grows excessively, acne appears, and sexual desire decreases. For treatment, drugs are prescribed that reduce the release of prolactin.
Papilloma inside the ducts. Neoplasms can occur in the lumen of the lactiferous duct, is a benign neoplasm. Pathology is observed in women who are over 40 years old. A characteristic symptom is bloody fluid from the nipple, with pressure or spontaneously. This can be seen if stains remain on the bra. For diagnosis, an analysis of discharge from the chest, ultrasound, and a histological examination are carried out.
Breast cancer is a disease that does not manifest itself in any way, for some time. Initial symptoms are bloody discharge. Characterized by an increase in the gland that is affected, the presence of a seal.
Paget's disease - considered rare, a form of cancer that affects the nipple. Deformation, retraction of the nipple into the chest is possible, darkening, redness occurs. There may be a burning sensation, itching.
Injured chest. After breast injuries, bloody fluid may appear, become lighter with healing.

What should be done when a symptom occurs?

If you experience strange discharge from the nipple, wait and treat yourself folk remedies it is forbidden. It is contraindicated to apply warm compresses, to warm the chest in other ways, it is possible to worsen inflammation in the tissues. You can not try to squeeze out the liquid, this increases the greater selection. Taking hormonal drugs is possible only on the recommendation of a doctor. When using a contraceptive on hormones, you need to consult a specialist about replacing it. To find out the cause of the pathology and prescribe treatment, you need to contact a mammologist and be examined.

Be sure to pay attention to the color of the liquid, to other symptoms of non-standard manifestations. In order not to miss the first symptoms of a serious illness, a woman needs to constantly examine her breasts for the presence of seals, secretions.

Minasyan Margarita

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?

The female breast contains milk ducts, which are located between the fibrous and adipose tissue. Each canal has an opening at the top of the nipple. For all women, the number of ducts is individual, but the maximum number can be up to fifteen. Through the lactiferous ducts, not only milk and colostrum are produced, but also physiological secretion.

In the absence of diseases, the influence of external negative factors for whitish, transparent discharge from the mammary glands, the following condition is inherent:

scarce and plentiful;
thick and watery;
viscous or slimy.

Any homogeneous consistency of secretion from the channels is the norm, but only against the background of a transparent shade of liquid and a small volume. If there is too much discharge, it is not recommended to postpone a visit to the mammologist.

For a certain condition, there are indicators of the norm of a physiological secret:

Scanty, thick (one or two drops). It is noted with pressure on the chest in young girls and nulliparous women a few days before menstruation and during increased sexual arousal.
Not very plentiful, liquid. They are characteristic of older women and women who have given birth, but the appearance of a thick liquid is not excluded.
Viscous. Colostrum occurs during gestation, feeding the child and for several years after the cessation of lactation (individual indicator).

gestation

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 ruled out 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 provokes discomfort ( general weakness, heat).

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:

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.
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 it is absent, and 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, the woman should contact medical institution 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:

Mastitis. Inflammatory process in the female breast without a clear localization.
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 the surgical opening of the milk ducts, followed by the 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.

Cancer

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.

The release of various liquids and masses from the nipples may be the result of normal physiological processes, or indicate the development of certain pathological phenomena in the body.

That is why it is important to be able to accurately establish the cause of such a symptom, and also to find out by the nature of the discharge what exactly such an event is talking about.

First and most common cause the appearance of secretions from the mammary glands is a natural process life cycle women - . The fluid that begins to stand out due to the structural restructuring of the mammary gland, called colostrum, is an intermediate link between lymph and milk.

Did you know? Small white pimples located on the areola of the nipples are called Montgomery's glands. Scientists are still arguing about their functional purpose. According to the most popular theory, the liquid from them is designed to lubricate the halo of the nipple.

The process of hormonal adjustment that occurs in a woman's body can lead to the appearance of discharge from the nipples on different stages pregnancy, starting from the very first, at any time during its course, and even after its completion, when colostrum begins to stand out instead of milk or along with it.

This phenomenon is primarily due to the restructuring of the glandular tissue of the mammary gland under the influence of huge doses.

It must be understood that after a woman has an abortion, her body needs some time to restore its usual hormonal levels.

Therefore, for some time after its commission, and before it, the appearance of some secretions from the mammary glands is also possible. Usually, for the complete cessation of all such manifestations, if they occur at all, 1-2 months are enough.

Sometimes it happens that, due to the peculiarities of the endocrine system, a woman's body releases hormones too actively during. Prolactin is one of these hormones. Because of this, the breast during these periods may increase in size and begin to secrete fluid.

It is performed using a special ultrasound machine with narrowly focused sensors that have a separating ability and parameters designed to analyze various structures that do not exceed the density of the pectoralis major muscle. This makes it possible to clearly distinguish areas of tumor and inflammatory processes from healthy tissue in the image.

Patients with inflammatory processes of the breast and physiological secretions are eliminated after visiting a mammologist, since most of them are well diagnosed during an external examination and a thorough clarification of the circumstances of the onset and course of the disease in the process of talking with the patient.
Mammography Before visiting a mammologist, it will not be superfluous to make a small list of information about your problem in advance, which would answer the following questions:

What is the color of the discharge coming from the nipple?
What is the regularity of this process?
Does the discharge come from one breast or both?
Does it flow from a certain area of the nipple, or from the entire nipple at once?
Do they flow spontaneously, or only after the application of physical effort?
Are there any other symptoms (absolutely any) that would make you uncomfortable?
Have you ever had a chest injury?
Do you take any medications on a regular basis?

If the doctor suspects any serious pathology, such as oncology or galactorrhea associated with endocrine disorders, the patient is sent for further examination. The first diagnostic method for a patient who presumably has these pathologies is a thorough analysis of the hormonal background.
It is important to assess all endocrinological parameters, including levels of sex hormones, releasing factors, thyroid and adrenal hormones, since it is not known for certain which part of the endocrine system could cause these disorders.

After that, if such a need arises, the patient is sent to the last stage of diagnosis - a biopsy., which helps to establish the nature and degree of development of oncological pathology.

Important! Often a special massage can help clear the breast of excess milk and pus. However, it must be remembered that it must be performed by a qualified specialist and, in some cases, under local anesthesia.

In order to cure inflammatory processes of the breast, various antibacterial agents are often used, the exact selection of which depends on the nature of the flora that caused them. Various warm compresses, antipyretics, and local anesthetics are used as symptomatic therapy.
In especially advanced cases, punctures of large abscesses are also used to treat these pathologies., as a result of which pus is pumped out of the cavities in the chest, and if this does not help, surgical operations are performed, the essence of which is to apply radian incisions on the chest, find especially large abscesses and abscesses and drain them.

All pathology, which is associated with problems in the work of the endocrinological apparatus, is reduced to the elimination of these problems.

For example, if galactorrhea is associated with a pituitary tumor, due to which too much prolactin is synthesized, then the pituitary gland is surgically or medically acted upon in such a way that the tumor decreases in size or disappears altogether. Ultimately, this leads to the resolution of the problem with discharge from the nipples.

As for oncological pathology, it all depends on many factors: the staging of the tumor, its malignancy, the involvement of regional lymph nodes in the process, etc.

Traditional methods of treating such a pathology are associated with the use of various highly toxic drugs that kill the tumor, as well as various radioisotope and surgical techniques aimed at eliminating or reducing the tumor in size.

To prevent the appearance of secretions of a very different nature from the chest, the following methods include:

scrupulous and thorough passage of all required medical preventive examinations (especially important for women after 45-50 years);
regular (1 time in 1-1.5 months) examinations at the mammologist;
following the rules of personal hygiene;
following the rules of breastfeeding;
try to expose your nipples to UV rays as little as possible, including in the solarium;
regularly check your hormonal spectrum, especially if you are prone to various pathological changes;
take care of the chest from various kinds of injuries, including blunt and domestic ones;
do not take oral contraceptives.

So, we hope that this article has helped you find out everything you want about the appearance of discharge of a different nature from the nipples. Remember that only qualified doctors will be able to properly diagnose and treat you, so if you have the slightest need, do not hesitate to contact them. Be healthy!

Discharge from the nipples is not always a pathology, even in postmenopausal women, but in men they are always a sign of pathology.

The discharge from the nipple can be serous (yellow), mucinous (clear and watery), white, bloody, purulent, multicolored or viscous, serosanguineous (pink). May occur spontaneously or in response to manipulation of the mammary glands.

Discharge from the nipples occurs for a variety of reasons, from the first symptom of an undiagnosed pregnancy to the late symptom of a mature carcinoma. Discharge in large quantities causes embarrassment and anxiety. Compared to hardening and pain, this is a relatively rare symptom. Take it seriously and evaluate it carefully, often additional examinations are needed.

Pathophysiology of discharge from the nipples of the breast in a woman

Discharge from the nipples can be breast milk or exudate due to various reasons.

Breast milk production in non-pregnant and non-lactating women (galactorrhea) is usually associated with elevated prolactin levels, which stimulate the glandular tissue of the breast. but elevated level prolactin does not necessarily lead to the development of galactorrhea.

Causes of discharge from the nipples of the breast in a woman

Frequent causes:

pregnancy;
duct papilloma;
duct ectasia;
acute mastitis/abscess;
nipple abscess (infection of the Montgomery gland).

Possible reasons:

taking oral contraceptives;
intraductal carcinoma;
neonatal and peripubertal galactorrhea (also after lactation);
hyperprolactinemia (drugs, prolactinoma, hypothyroidism);
proliferation of the epithelium of the ducts;
galactocele.

Rare causes:

periductal (plasmocytic) mastitis;
mechanical stimulation;
invasive cancer;
tuberculous abscess;
fistula of the ducts of the mammary gland;
Paget's nipple cancer;
mastitis on the background of acne.

comparison table

	Pregnancy	Papilloma	ectasia	Mastitis	Nipple abscess
admixture of blood	Not	Yes	Possible	Possible	Possible
Multi-colored / caseous	Not	Not	Yes	Not	Not
Purulent character	Not	Not	Not	Yes	Yes
Hot section	Not	Not	Not	Yes	Yes
Bilateral highlights	Yes	Not	Possible	Not	Not

As a rule, discharge from the nipples is benign. Cancer (often intraductal or invasive ductal) is the cause of discharge into<10% случаев. В остальных случаях выделения могут быть результатом доброкачественных изменений протоков молочных желез (внутрипротоковой папилломы, протоковой эктазии, фиброзно-кистозных изменений), эндокринных нарушений, абсцессов или инфекций молочных желез. Наиболее распространенной причиной является внутрипротоковая папиллома, вызывающая кровянистые выделения из сосков без образования опухоли в молочной железе.

Endocrine causes are characterized by an increase in prolactin levels for various reasons.

Benign processes in the mammary glands:

Cause	Manifestations	Diagnostic approach
Intraductal papilloma	Unilateral bloody (or guaiac-positive, i.e. containing trace amounts of blood) or serum-blood discharge
Ductal ectasia of the mammary glands	Unilateral or bilateral bloody (or guaiac-positive), composed of serum and blood, or multicolored (purulent, gray or white) discharge	Diagnosed in the same way as breast tumors
Fibrocystic changes	Lumps, often rubbery to the touch and painful, tend to develop in menopausal women Possible history of other lesions	Diagnosed in the same way as breast tumors
Abscess or infection	Acute onset with pain, tenderness, or erythema Abscess may be tender and purulent	Clinical examination If treatment of discharge is ineffective, the same examination as for breast tumors is recommended.

Mammary cancer:

Hyperprolactinemia:

Examination for discharge from the nipples of the breast in a woman

Examination methods

Main: not required (referral for biopsy/mammography in suspicious cases).

Additional: pregnancy test, prolactin level, thyroid function assessment.

Auxiliary: smear of purulent discharge.

Pregnancy test if it is suspected.
Smear of purulent discharge: will help prescribe antibiotic therapy.
Prolactin levels, thyroid function tests will help check for hyperprolactinemia or hypothyroidism with galactorrhea.
Excisional biopsy: necessary if a suspicious nodule is palpated. In doubtful cases, mammography helps; surgery may also be considered in cases where pressure on one side of the breast causes discharge from the nipple.

Disease history. The history of the present education should include whether the discharge is unilateral or bilateral, what color it is, how long it has lasted, whether it is spontaneous or occurs with nipple stimulation, and whether lump or pain is present.

A review of symptoms should include identification and possible causes, including fever; cold intolerance, constipation, or weight gain (hypothyroidism); amenorrhea, infertility, headache, visual disturbances (pituitary tumor); ascites or jaundice (liver disease).

History should include information about possible causes of hyperprolactinemia, including chronic renal failure, pregnancy, liver and thyroid disorders, as well as data on infertility, hypertension, depression, breastfeeding, menstrual cycle and cancer. The physician should also ask specifically about taking drugs that can cause prolactin release, such as oral contraceptives, antihypertensives (methyldopa, reserpine, verapamil), H3 antagonists (cimetidine, ranitidine), opiates, and dopamine D2 antagonists (eg, many psychotropic drugs including phenothiazines and tricyclic antidepressants).

Physical examination. The mammary glands are carefully examined. Check their symmetry, the presence of irregularities on the skin, erythema, swelling, discoloration of the nipples and skin, the presence of crusts, ulceration, retraction of the nipple. The mammary glands are palpated in order to detect neoplasms, enlarged lymph nodes in the axillary or supraclavicular regions. If there is no spontaneous discharge, the area around the nipples is systematically palpated to stimulate possible discharge. With the help of intense illumination and a magnifying glass, it is established whether the discharges are single-stream or multi-stream.

Warning signs. Some manifestations require special attention:

spontaneous discharge,
age >40,
unilateral discharge,
bloody or guaiac-positive discharge,
palpable neoplasm,
male.

Interpretation of the revealed signs. It is important to establish whether a neoplasm is present, whether the discharge is single-duct or multi-duct (one or more ducts in both breasts or more than one duct in one breast), and whether the discharge is bloody (including guaiac-positive).
If education is present, the possibility of cancer should be considered. Because cancer rarely involves both breasts or multiple ducts, bilateral guaiac-negative discharges usually have an endocrine cause, as do unilateral multiductal discharges. However, if the discharge is guaiac-positive or involves only one duct, the possibility of cancer should be considered.

Survey. If endocrine disorders are suspected, the following is performed:

prolactin level,
thyrestimulating hormone (TSH) levels.

If the discharges are guaiac-positive, the following is performed:

cytological analysis.

In the presence of a palpable mass, the same examination is performed as in the presence of a lump in the mammary gland, usually starting with ultrasonography.

Masses that are suspected to be cystic are sometimes aspirated, and hard lumps or lumps that do not disappear after aspiration are examined using targeted biopsy mammography.

If the neoplasm is not detected, but cancer is suspected for other signs, as well as in case of failure of other tests - mammography.

Findings indicative of pathology are assessed by targeted biopsy. If the seal is not palpable and the mammogram does not show abnormalities, the likelihood of cancer is extremely small.

Women who come with complaints of discharge from the nipples are most likely afraid that this is a manifestation of cancer. To finally calm them down, convince them that you can solve this problem.

If the discharge is bilateral, then the likelihood of a serious illness is small.

Women of childbearing age with bilateral profuse discharge should be asked about pregnancy: some deliberately hide it, while others really forget to mention it.

In premenopausal women with amenorrhea, bilateral discharge, and pregnancy excluded, prolactin levels should be assessed.

Women over 50 years of age with new onset discharge (unless there are obvious benign causes) and all women with bloody discharge should be referred to a specialist to rule out a serious pathology.

If palpation of the lump or pressure on a specific area of the breast causes nipple discharge, refer the patient for an excisional biopsy.

Bright red blood from one nipple suggests papilloma or ductal carcinoma.

Discharge from the nipples in men is always a pathology, with the exception of rare cases during puberty. Examine the patient yourself or refer to the appropriate specialist.

Treatment of discharge from the nipples of the breast in a woman

Treatment is based on the cause of the disease. If the discharge has a benign origin and a constant irritating character, it is necessary to perform a resection of the nipple duct flap.