One of the common symptoms of patients visiting the breast surgery department for breast problems is ‘nipple discharge’. Nipple discharge is known as one of the three most common breast symptoms along with mastalgia and mass. In more than 80% of women, it is a physiological phenomenon caused by hormones and may appear temporarily without any particular cause. However, it can be an abnormal signal due to breast cancer or various breast diseases, so it is good to undergo a detailed examination to accurately determine the cause.
The cause of nipple discharge can be caused by hormonal changes during childbirth or breastfeeding, and external stimulation or excessive pressure, such as wearing tight underwear, can also cause nipple discharge. Or, it can also occur under the influence of various types of drugs, such as birth control pills, female hormone therapy for menopausal women, stomach medicines, sedatives, and sleeping pills.
In case of pituitary adenoma, prolactin level test is required. At this time, if the prolactin level is 100ng/ml, it is necessary to check whether or not it is a benign tumor, prolactinoma, through brain MRI.
The most common cause of pathological papillary secretion is intraductal papilloma. Although the lesion is classified as benign, it is recommended to confirm it through resection as it may be accompanied by dysplasia or ductal carcinoma in situ.
Galactorrhea due to benign breast disease, such as ectasia of the ducts, is when discharge is mixed in color, such as green or gray, and the cause can be identified through testing. On the other hand, if the secretion comes out on its own even though the nipple is not stimulated, or if bloody secretions come out of one nipple hole in one breast, breast cancer should be suspected.
The symptoms of nipple discharge from benign breast disease and pathologic breast disease are different. In the case of benign breast disease, it is mostly bilateral, and it is secreted from several milk ducts and secreted when pressed. On the other hand, in the case of malignant breast disease △occurs only on one side △occurs in a single milk duct △occurs spontaneously or occurs accompanied by blood or serous blood or nodule △occurs in a woman over 40 years of age, the risk of breast cancer is getting higher In this case, it must be confirmed by breast cancer screening.
Written = Director Lee Joo-hyun, medical reporter at Haidak (surgeon)
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