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What Causes Nipple Discharge And Dense Breasts?
Question: HI Dr Robinson-
I have had nipple discharge from my left breast. I first noticed it during a self breast exam. It did not come out on its own - only when the nipple was pressed on near the top. It was a thin clearish/slightly pale yellow fluid and seems to only be coming out of one duct. The first time I noticed it was back in Feb 2014. At the time I was on the birth control pill to control heavy cycles. I had a diagnostic u/s and mammogram- both came back normal but was told I have dense breasts.
I was also told that the pill could be causing it so I was told to stop taking it.
Just last month I barely pressed on the same nipple area and the same type of fluid came out. I had a repeat ultrasound of that breast- results were normal again.
I am obviously concerned that it could be something more bc everything I have read is saying single duct is not normal. The breast specialist I was referred to by my GYN said that it could be hormonal? I have had blood work, prolactin checked and it all came back normal. I am 41 yrs old and breastfed both of my children. I always noticed that the left breast produced more milk- this was years ago. Is it possible to have one breast that is more hormonal then the other??
I have had nipple discharge from my left breast. I first noticed it during a self breast exam. It did not come out on its own - only when the nipple was pressed on near the top. It was a thin clearish/slightly pale yellow fluid and seems to only be coming out of one duct. The first time I noticed it was back in Feb 2014. At the time I was on the birth control pill to control heavy cycles. I had a diagnostic u/s and mammogram- both came back normal but was told I have dense breasts.
I was also told that the pill could be causing it so I was told to stop taking it.
Just last month I barely pressed on the same nipple area and the same type of fluid came out. I had a repeat ultrasound of that breast- results were normal again.
I am obviously concerned that it could be something more bc everything I have read is saying single duct is not normal. The breast specialist I was referred to by my GYN said that it could be hormonal? I have had blood work, prolactin checked and it all came back normal. I am 41 yrs old and breastfed both of my children. I always noticed that the left breast produced more milk- this was years ago. Is it possible to have one breast that is more hormonal then the other??
Brief Answer:
Tough question
Detailed Answer:
Hello XXXXXXX
It is not really possible for one breast to have more hormonal stimulation than the other but it is possible for one breast to respond differently than the other. It sounds like you have had all the appropriate testing. The first thing I think of when I have a patient with this with normal mammogram and US is a prolactinoma. It is good that they checked a prolactin level and that it is normal so that rules out prolactinoma. One other test that you could ask your doctor for is an evaluation of the fluid that comes from the nipple. Sometimes that will give us a cause for discharge. It does not sound like anything dangerous, but I am sure it can be annoying and concerning. Good luck and hopefully this will resolve without treatment.
Tough question
Detailed Answer:
Hello XXXXXXX
It is not really possible for one breast to have more hormonal stimulation than the other but it is possible for one breast to respond differently than the other. It sounds like you have had all the appropriate testing. The first thing I think of when I have a patient with this with normal mammogram and US is a prolactinoma. It is good that they checked a prolactin level and that it is normal so that rules out prolactinoma. One other test that you could ask your doctor for is an evaluation of the fluid that comes from the nipple. Sometimes that will give us a cause for discharge. It does not sound like anything dangerous, but I am sure it can be annoying and concerning. Good luck and hopefully this will resolve without treatment.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I had my prolactin levels checked and they were normal. Also I had a sample of the fluid checked and that was normal. I was told that my hormone levels were indicating premenopause. I just would like to know definitively what the fluid is- I suppose it has been there and I did not know until I checked. With the hyper awareness I breast cancer I want to be thorough.
Brief Answer:
What they look for
Detailed Answer: XXXXXXX I am glad that you had the fluid looked at. When they examine the fluid they look for abnormal cells. Mostly the fluid is just like serum in the blood. Any body part can ooze serum like fluid and we do not always know why it happened. If you had mammogram, US, prolactin and fluid check then it sounds like you are covered and nothing serious is going on. It could be that you are in that perimenopausal time when hormones fluctuate. Try to make the best of it and not worry, it really does not sound like anything serious.
What they look for
Detailed Answer: XXXXXXX I am glad that you had the fluid looked at. When they examine the fluid they look for abnormal cells. Mostly the fluid is just like serum in the blood. Any body part can ooze serum like fluid and we do not always know why it happened. If you had mammogram, US, prolactin and fluid check then it sounds like you are covered and nothing serious is going on. It could be that you are in that perimenopausal time when hormones fluctuate. Try to make the best of it and not worry, it really does not sound like anything serious.
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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