Nipple Discharge: When Should I Worry?

Because breast cancer has been the subject of so much media attention and marketing, most American women know this message by heart: changes in your breasts should be reported to your doctor.

Unfortunately, it’s difficult to know which changes are truly serious, and which are nothing more than a temporary hormonal issue, an allergic skin reaction, or a harmless cyst. Surely we want to protect ourselves from cancer; and just as surely we don’t want to run to the doctor with every breast pain or patch of rough skin around our nipples.

Every day women write to us via the Q & A section on this site, asking if the change they see in their breast(s) is a symptom of cancer. Asking questions here at mybreastcancernetwork.com is a good first step, a place to get advice about breast-health issues that might be related to cancer. As expert patients, we use our laymen’s knowledge to assuage your fears, or kick you into gear—whichever is necessary. But, caveat emptor: we’re not doctors. YOU are ultimately the one who has to assess whether your issue warrants medical attention. 

Nipple discharge, a subject that comes up regularly, seems to produce a lot of waffling: is this worth a doctor’s visit, or not? You ask, “What does it mean? Is it dangerous? Should I worry?”

The following description of types of nipple discharge, and their causes, may help you answer those questions.

“There’s liquid coming out of my nipples…”
Unless it’s breast milk, this is called nipple discharge. There are about 10 tiny openings in each of your nipples, and not only breast milk, but any other liquid from inside your breast can seep out of these openings. This liquid may be thin and clear, almost like water; or thick and dark-colored; or just about anything in between. It may come out on its own, or only when you squeeze your nipples.

“It’s (greenish) (bloody) (yellowish) (thick)—should I be worried?”
•Bloody discharge: Generally, the one type of discharge you should worry most about, since it can signal cancer, is bloody: red to dark brown. And it would only be a cancer symptom if it occurred in ONE breast, not both. A bloody discharge doesn’t necessarily mean you have cancer; it can also be the result of a blow to the breast, or a benign papilloma (a small growth in the milk duct). But it means cancer is a possibility, and you should definitely get it checked by a doctor.

•Thick/sticky green/black discharge: This is usually the result of mammary duct ectasia, a problem that’s fairly common in women in their 40s and 50s. It’s an inflammation of one or more milk ducts, much like an internal pimple. It may be painful, but often isn’t. Have your doctor check it to see whether it’s extensive enough that you need an antibiotic.

•White, clear, yellow, or light green discharge: This is often a sign of galactorrhea, a hormonal imbalance. It should be checked with a doctor not because it’s a danger sign for breast disease, but because it might signal a problem elsewhere in your body, such as an underactive thyroid, or a pituitary disorder.