Monday 25 February 2013

Nipple discharge - 2

Abnormal nipple discharge:



Causes :
- Galactorrhea: watery or milk discharge in women who are non pregnant or not breast feeding is called galactorrhea.
 Causes: Over production of prolaction from pituitary gland can led to it.
Prolactinoma, the non cancerous tumor of pituitary gland  can cause this.         
Hypothyroidism can lead to increased production of prolaction due to TSH stimulation and can cause galactorrhea.
Drugs like antipsychotic medicines, antacids, some hormones, herbs like anise, fennel and illegal drugs like marijuana etc can cause galactorrhea.
-          Breast infection :  also called as mastitis. The breast will appear sore, red and warm to touch.
Usually seen in breast feeding mothers. When milk ducts get blocked and infected pus discharge from nipples can occur.  
In non breast feeding women, causes like smoking may cause inflammation of the milk ducts and produce pus containing nipple discharge.

-          Fibrocystic breast changes:
Development of fibrous tissue and cysts in breast occurs.
That can cause formation of lumps or thickening.
Causes pain and itching.
Sometimes can lead to clear, white, yellow or green nipple discharge.
          
-          Mammary duct ectasia:
Second most common cause of abnormal nipple discharge.
Usually seen in women who are approaching menopause.  
In duct ectasia inflammation and possible blockage of ducts located underneath the nipple can be seen.
Superadded infection can lead to thick and greenish nipple discharge. 

-          Breast tumors:

-          Intraductal papilloma:
Non cancerous growth in the ducts of the breasts.
Most common cause of abnormal nipple discharge.
When the ducal papillomas get inflamed they may result in nipple discharge that contains blood and sticky fluid.

-          Breast carcinoma:
Sometimes breast carcinoma can cause watery or blood stained nipple discharge when the tumor invades the ducts.
If a patient presents with nipple discharge accompanied by a lump or mass within the breast or with abnormal mammogram.

Intraductal carcinoma: It develops within the ducts of the breast located beneath the nipple and can cause nipple discharge.

Pagets disease: develops in the ducts of the breast and then moves to nipple.
It can cause nipple and surrounding areas to bleed or ooze.
It usually accompanied by another form of breast cancer.


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