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Nipple Discharge


Mary Ann Kosir

, MD, Wayne State University School of Medicine

Reviewed/Revised Feb 2024
Topic Resources

Fluid that leaks from one or both nipples is called nipple discharge. Each breast has several (15 to 20) milk ducts. A discharge can come from one or more of these ducts.

Nipple discharge can occur normally during the last weeks of pregnancy and after childbirth when breast milk is produced. A nipple discharge can also be caused by breast stimulation in women who are not pregnant or breastfeeding, especially during the reproductive years. However, a nipple discharge in men is always abnormal.

A normal nipple discharge is usually a thin, cloudy, whitish, or almost clear fluid. However, the discharge may be other colors, such as gray, green, yellow, or brown. A bloody discharge is abnormal.

Abnormal discharges vary in appearance depending on the cause. An abnormal discharge may be accompanied by other abnormalities, such as dimpled skin, swelling, redness, crusting, sores, and an inverted (retracted) nipple. (A nipple is inverted if it pulls inward and does not return to its normal position when it is stimulated.) If a discharge from only one breast occurs on its own (without any stimulation of the nipple), it is considered abnormal.

Causes of Nipple Discharge

Several disorders can cause an abnormal discharge.

A discharge from both breasts or from several milk ducts in one breast is more likely to be caused by a problem outside the breast, such as a hormonal disorder or use of certain medications.

Common causes of a nipple discharge

Usually, the cause is a benign disorder of the milk ducts, such as the following:

Intraductal papilloma is the most common cause. It is also the most common cause of a bloody nipple discharge when there is no lump in the breast.

Less common causes of a nipple discharge

Certain disorders stimulate the production of breast milk in women who are not pregnant or breastfeeding (see table ). In most of these disorders, the level of prolactin (a hormone that stimulates production of breast milk) is elevated. Taking certain medications can have the same effect.

Cancer causes fewer than 10% of cases.

Evaluation of Nipple Discharge

Warning signs

Nipple discharge is a cause for concern when it

  • Is accompanied by a lump that can be felt

  • Is bloody or pink

  • Comes from only one breast

  • Occurs without the nipple's being squeezed or stimulated by other means (when it occurs spontaneously)

  • Occurs in women aged 40 or older

  • Occurs in a boy or man

When to see a doctor

If a nipple discharge continues for more than one menstrual cycle or if any of the warning signs are present, women (or men) should see a doctor. Delay of a week or so is not harmful unless there are signs of infection such as redness, swelling, and/or a discharge of pus. Women with such symptoms should see a doctor within 1 or 2 days.

What the doctor does

Doctors first ask questions about a woman's symptoms and medical history. Doctors then do a breast examination. What they find during the history and breast examination often suggests a cause of the discharge and the tests that may need to be done (see table ).

To help identify the cause, doctors ask about the discharge and about other symptoms that may suggest possible causes. They ask

Women are also asked whether they have had disorders or take medications that can increase prolactin levels.

Doctors examine the breast, looking for abnormalities, including lumps Warning signs A breast lump (mass) is a thickening or bump that feels different from surrounding breast tissue. A lump may be discovered by a woman or during a breast examination by a doctor. (See also Overview... read more . If the discharge does not occur spontaneously, the area around the nipples is gently pressed to try to stimulate a discharge.

Doctors also feel the lymph nodes in the armpits and above the collarbone to check for enlarged lymph nodes.



If doctors suspect that a hormonal disorder is the cause, blood tests are done to measure the levels of prolactin and thyroid-stimulating hormone.

If a pituitary or brain disorder is suspected, magnetic resonance imaging (MRI) or computed tomography (CT) of the head is done.

If the discharge is not obviously bloody, it is analyzed to determine whether it contains small amounts of blood. If blood is present, a sample of the discharge is examined under a microscope (called cytology) to look for cancer cells.

Cysts are drained (by aspiration), and the fluid is tested. If the fluid is bloody, it is checked for cancer cells.

If lumps are solid, mammography is done, followed by a biopsy.

When there is no lump but cancer is still suspected or when other test results are unclear, mammography is done.

If test results after aspiration, ultrasonography, or mammography are abnormal, a biopsy is done.

If ultrasonography and mammography do not identify a cause and the discharge occurs spontaneously and comes from one milk duct, doctors usually do a special type of mammogram (called a ductogram, or galactogram). For this procedure, a contrast agent (which helps make images clearer) is injected into the duct, and images are taken, just as for a regular mammogram. This test can help rule out or identify cancer.

If no lump can be felt and the mammogram is normal, cancer is highly unlikely.

Sometimes a specific cause cannot be identified.

If women have any of the following, they should see a doctor who is experienced in managing breast disorders:

  • A lump in the breast

  • A bloody or pink discharge

  • A spontaneous discharge from one breast

  • An abnormality previously detected by mammography or ultrasonography

Treatment of Nipple Discharge

If a disorder is identified, it is treated.

If a noncancerous tumor or disorder is causing a discharge from one breast, the duct that the discharge is coming from may be removed. This procedure requires only a local anesthetic and does not require an overnight stay in the hospital.

Key Points

  • Usually, the cause of nipple discharge is not cancer.

  • If the discharge comes from both breasts or from several milk ducts and is not bloody or pink, the cause is usually a noncancerous hormonal disorder.

  • If the discharge comes from only one breast and is bloody or pink, cancer is possible, especially in women aged 40 or older.

  • Whether blood tests, imaging (such as ultrasonography), or both, are done depends on the suspected cause.

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