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What Causes Brown Sticky Drainage From Nipple?
Question: Hi - I noticed a couple of weeks ago some brown, sticky drainage on my left nipple. It was a very tiny amount, about the size of a ballpoint pin tip. Since that time, it is draining more and now it is more of a dark red color. It looks like blood and is very sticky. There is no odor that I can smell. It pretty much seeps out on its own when my clothing rubs against it, when I'm bathing and of course, during sexual arousal. I just had a mammogram about 6 weeks ago. In the past, I've had an ultrasound on the right breast because of inflamed ducts but they are OK and I've never had any drainage from the right side. This drainage on the left is something completely new and it's frightening. I alrwady have an appointent with my GP in a couple of weeks for my annual pap/pelvic/breast exam. Should I try and get in earlier to see her or try to see a specialist? Can you tell me what this might be and could it be cancer? I have no family history of breast cancer and with the exception of the inflammation, I've never had any breast issues. Any response you can give me will help me know what to do with this. Thank you so much.
I just attached a photo. Thank you!
I just attached a photo. Thank you!
Brief Answer:
Duct ectasia or duct papilloma likely, dont worry much.
Detailed Answer:
Hello
THanks for writing to us with your health concern.
You mentioned that you had an ultrasound on the right breast due to inflamed ducts, but no drainage from there ?
So what were your symptoms then ?
With a normal mammogram 6 weeks back, and no ominous history - cancer is least likely.
A breast exam a couple of weeks from now is fine.
Commonest reasons for a blood stained discharge include - intraductal papilloma and duct ectasia - technical terms , but in essence, non malignant ductal issues, and yes, inflammation too.
Cancer of the ducts of course is a reason, and hence a workup is essential.
Duct ectasia is common in menopausal women and is a type of inflammation, and duct papilloma is a non cancerous growth inside the ducts.
Both can cause such discharge.
I think one of the two is likely, but yes, cancer has always to be ruled out .
If you can see a SPecialist earlier, do so, otherwise a couple of weeks is fine, but then the referral to a Specialist by your GP should not take inordinately long.
A cancer is more likely if there was a palpable lump / mass, an abnormal mammogram or a sinister family / personal history.
Please relax.
All the best
Please feel free to discuss further.
Duct ectasia or duct papilloma likely, dont worry much.
Detailed Answer:
Hello
THanks for writing to us with your health concern.
You mentioned that you had an ultrasound on the right breast due to inflamed ducts, but no drainage from there ?
So what were your symptoms then ?
With a normal mammogram 6 weeks back, and no ominous history - cancer is least likely.
A breast exam a couple of weeks from now is fine.
Commonest reasons for a blood stained discharge include - intraductal papilloma and duct ectasia - technical terms , but in essence, non malignant ductal issues, and yes, inflammation too.
Cancer of the ducts of course is a reason, and hence a workup is essential.
Duct ectasia is common in menopausal women and is a type of inflammation, and duct papilloma is a non cancerous growth inside the ducts.
Both can cause such discharge.
I think one of the two is likely, but yes, cancer has always to be ruled out .
If you can see a SPecialist earlier, do so, otherwise a couple of weeks is fine, but then the referral to a Specialist by your GP should not take inordinately long.
A cancer is more likely if there was a palpable lump / mass, an abnormal mammogram or a sinister family / personal history.
Please relax.
All the best
Please feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much. I will try to not worry. My appointment with my GP Is one week from today. You mentioned a specialist -- will it be necessary to see a specialist? What is a reasonable time to wait for a specialist appointment? And finally, what would be the treatment they will need to do? Would this require a biopsy? The right side inflammation was seen on a routine mammogram and they called me back for an ultrasound and then another follow-up US six months later. Thanks again for your prompt response.
Brief Answer:
Can see a Specialist in a fortnight ; workup outlined.
Detailed Answer:
Thank you for the appreciation.
Yes, I think it is necessary to consult a Specialist, and you should have that done within 2 weeks from now if possible.
Initially they would perform the following -
1. Physical exam
2. Mammography with breast ultrasound scan.
3. Lavage ( washing ) of the duct with cytological exam of the washings.
Once any of the tests are positive, Traditional treatment is surgical excision of the involved ductal system from which the discharge emanates. This is often done via live ultrasound image guidance or via duct endoscopy ( visualization of the interior of the duct with a flexible wire guided camera )
Hope this helps.
Take care, and keep me posted as and when the need arises.
Can see a Specialist in a fortnight ; workup outlined.
Detailed Answer:
Thank you for the appreciation.
Yes, I think it is necessary to consult a Specialist, and you should have that done within 2 weeks from now if possible.
Initially they would perform the following -
1. Physical exam
2. Mammography with breast ultrasound scan.
3. Lavage ( washing ) of the duct with cytological exam of the washings.
Once any of the tests are positive, Traditional treatment is surgical excision of the involved ductal system from which the discharge emanates. This is often done via live ultrasound image guidance or via duct endoscopy ( visualization of the interior of the duct with a flexible wire guided camera )
Hope this helps.
Take care, and keep me posted as and when the need arises.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You have been so kind to answer all my questions. I feel like I am facing this challenge with good information and an understanding of what should be done. I have an additional question. How long does it take a pappaloma to develop? Shouldn't this have been detected on my mammogram 6 weeks ago? And if not, has it developed that rapidly? Thank you!!!
Brief Answer:
Initial changes might have been missed.
Detailed Answer:
Hi again.
Thank you for the appreciation, makes my day !
Yes, regarding the changes for a papilloma or duct ectasia to develop, it takes a few weeks.
It is well nigh possible that the subtle initiation of the changes might have been missed on a routine screening mammogram, particularly since you were not symptomatic ( thereby not prompting suspicion to minutely look at the area ) and also since an ultrasound scan was not done in conjunction with the mammogram.
Hope this clears your doubt.
Please stay in touch whenever you feel the need to do so.
You can write in directly anytime using the following link -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.
Initial changes might have been missed.
Detailed Answer:
Hi again.
Thank you for the appreciation, makes my day !
Yes, regarding the changes for a papilloma or duct ectasia to develop, it takes a few weeks.
It is well nigh possible that the subtle initiation of the changes might have been missed on a routine screening mammogram, particularly since you were not symptomatic ( thereby not prompting suspicion to minutely look at the area ) and also since an ultrasound scan was not done in conjunction with the mammogram.
Hope this clears your doubt.
Please stay in touch whenever you feel the need to do so.
You can write in directly anytime using the following link -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hi again. I talked to my doctors nurse on Friday and she was able to contact my doctor. they scheduled me for a mammogram with ultrasound Monday morning at 8:30 am. it is now saturday. I will see my doctor Tuesday afternoon. will the radiologist go ahead and do a ductoscopy on monday when they do the ultrasound? I was surprised it wasn't ordered as well but thought maybe it is done at the radiologists discretion. please advise. thank you again for your help.
Brief Answer:
It would be done only if imaging is equivocal.
Detailed Answer:
Hi again.
The ductoscopy would not be done right away.
If the diagnosis is not clear on the mammogram plus scan, only then is a ductoscopy or lavage necessary.
If the lesion is clear enough on imaging, there is no need for further evaluation.
Wish you luck.
Keep me posted.
And yes, may the new year usher in great positivity for you.
It would be done only if imaging is equivocal.
Detailed Answer:
Hi again.
The ductoscopy would not be done right away.
If the diagnosis is not clear on the mammogram plus scan, only then is a ductoscopy or lavage necessary.
If the lesion is clear enough on imaging, there is no need for further evaluation.
Wish you luck.
Keep me posted.
And yes, may the new year usher in great positivity for you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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