Cause | Common Features* | Tests |
---|---|---|
Benign breast disorders | ||
Intraductal papilloma (a benign tumor in a milk duct)—the most common cause | A bloody or pink discharge from one breast | Usually ultrasonography Additional tests, such as mammography, MRI, or a ductogram (mammogram of the milk ducts) depending on the results of ultrasonography Biopsy if other tests cannot rule out cancer |
Mammary duct ectasia (dilated milk ducts) | A bloody, pink, or multicolored (puslike, gray, or milky), sometimes thick or sticky discharge from one or both breasts | Same as for intraductal papilloma |
Fibrocystic changes Fibrocystic Changes of the Breast Fibrocystic changes of the breast (formerly called fibrocystic breast disease) include breast pain, cysts, and lumpiness that are not due to cancer. (See also Overview of Breast Disorders and... read more (including pain, cysts, and general lumpiness) | A lump, often rubbery and tender, usually developing before menopause Possibly a pale yellow, green, or white discharge Possibly a history of having breast lumps | Same as for intraductal papilloma |
Pain, tenderness, redness, warmth, or a combination that begins suddenly in a breast Often fever With an abscess, a tender lump and possibly a puslike discharge that smells foul | Breast examination If the discharge does not resolve with treatment, evaluation as for intraductal papilloma | |
Nipple discharge† | Possibly a palpable lump, changes in the skin, or enlarged lymph nodes, most often in the armpit Sometimes a bloody or pink discharge | Same as for intraductal papilloma |
Increased levels of prolactin‡ | ||
Various disorders, including the following: | A milky (not bloody) discharge, usually from both breasts No lumps Possibly menstrual irregularities or no menstrual periods (amenorrhea) | Blood tests to measure prolactin and thyroid-stimulating hormone levels A review of medications being taken If the prolactin or thyroid-stimulating level is elevated, MRI of the head |
Intolerance of cold, sluggishness, constipation, or weight gain | ||
| Possibly hormonal abnormalities (such as absence of menstrual periods or infertility), changes in vision, or headaches | |
| With liver disorders, ascites or jaundice In people known to have a kidney or liver disorder | |
Certain medications including
| — | Blood tests to measure prolactin and thyroid-stimulating hormone levels A review of medications being taken If the prolactin or thyroid-stimulating level is elevated, MRI of the head |
* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. | ||
† Nipple discharge is usually caused by intraductal carcinoma or invasive ductal carcinoma. | ||
‡ Prolactin is a hormone that stimulates production of breast milk. | ||
§ Ranitidine (taken by mouth, intravenously, and over the counter) has been removed from the market in the United States and in many other countries because of unacceptable levels of N-nitrosodimethylamine (NDMA), which is a substance that probably causes cancer. | ||
MRI = magnetic resonance imaging. |