Does nipple discharge mean breast cancer? It could be another disease

Nipple discharge is one of the common symptoms of breast disease. If nipple discharge occurs, you must seek medical attention promptly to avoid delaying the condition.

Causes and types of nipple discharge

Nipple discharge can be divided into physiological discharge and pathological discharge.

Physiological discharge refers to the phenomenon of lactation during pregnancy and lactation. Women will still secrete a small amount of milk within one year after stopping breastfeeding; in the middle and late stages of pregnancy, some pregnant women can squeeze out a small amount of light-colored colostrum from their breasts; after entering menopause, some women will secrete a small amount of milk due to endocrine disorders.

In addition, oral hormonal drugs such as morphine, reserpine, metoclopramide, imipramine, methyldopa and birth control pills can also stimulate the secretion of prolactin and lead to nipple discharge. Local stimulation of the breast and systemic stress response, such as severe mental trauma and sudden changes in living habits, can also lead to nipple discharge.

Pathological discharge refers to the natural discharge from one or more ducts of one or both nipples under non-physiological circumstances and unrelated to pregnancy and lactation. This discharge is intermittent and continuous, and the duration ranges from several months to several years.

Pathological nipple discharge is often related to the following breast diseases.

1. Mammary duct ectasia

Nipple discharge is an early symptom of mammary duct ectasia. The color of the discharge is mostly brown, and the discharge test shows a large number of plasma cells and lymphocytes but no cancer cells. If the disease is combined with infection, the tumor will show inflammation symptoms such as redness, swelling, heat, and pain.

This disease often occurs in non-lactating or menopausal women over 40 years old.

2. Intraductal papilloma

The main clinical manifestation of intraductal papilloma is bloody nipple discharge. If you touch the breast carefully, you can find a cherry-sized mass under the areola, which often occurs alone or in multiples in the dilated milk ducts near the nipple. It is soft, smooth and easy to move. Laboratory examination can find tumor cells in the discharge. Although the tumor is small, it is rich in blood vessels and is very easy to bleed.

Intraductal papilloma is more common in women aged 40-50 years.

3. Breast cystic hyperplasia

This is a common disease in women of childbearing age. Some patients have yellow-green, brown, bloody or colorless serous discharge from the nipple. Laboratory tests show that no tumor cells are found in the discharge. In addition to discharge, the disease has two other characteristics: one is periodic breast pain, which is more likely to occur or worsen before menstruation; the other is that breast lumps are often multiple and can be seen on one or both sides, or can be limited to a part of the breast or scattered throughout the breast.

4. Breast cancer

Breast cancer patients often have bright red or dark red nipple discharge, sometimes clear water discharge, colorless and transparent, occasionally sticky. After the discharge is tested, cancer cells can be found. The two peak incidence periods of this disease are 45-49 years old and 60-64 years old. In the late stage of the lesion, orange peel-like changes or satellite nodules will appear.

Here we will introduce how to distinguish whether nipple discharge is physiological or pathological.

Usually, unilateral nipple discharge is mostly pathological, while bilateral nipple discharge is mostly physiological. The nipple has 15-20 milk duct openings. If discharge overflows from a single hole, it is mostly intraductal papilloma. If discharge overflows from multiple holes, it may be physiological, drug-induced, systemic benign diseases or breast hyperplasia. In addition, discharge that overflows spontaneously is mostly pathological, and about 13% of breast cancer patients have a history of spontaneous discharge. Benign or physiological discharge is usually seen after squeezing.

For physiological discharge, you don't need to worry too much. You can usually relieve the symptoms by adjusting your diet and endocrine system. But if it is pathological discharge, you must go to the hospital in time for a smear cytology test of the discharge, and receive targeted treatment after the diagnosis is confirmed.

Most nipple discharge is caused by cystic hyperplasia or inflammation of the breast. Such lesions can be effectively controlled by medication and a light diet. If it is a tumor discharge, it is usually caused by intraductal papilloma or breast cancer. The former should be treated with local segmental resection, while the latter should be surgically removed.

Since nipple discharge often occurs after menopause, menopausal women should put more effort into breast health care. They should exercise more, maintain good living habits, and have a balanced diet. They should strengthen breast self-examination, go to a specialist hospital for a physical examination once a year, pay attention to subtle changes in the breasts at any time, and immediately check and treat any problems. It is worth mentioning that menopausal women should be cautious when taking hormone replacement agents, and if they do, they must do so under the guidance of a doctor.