Деякі причини виділень із сосків

Benign breast disorders

Intraductal papilloma (most common cause)

Unilateral bloody (or guaiac-positive) or serosanguinous discharge

Evaluation as for breast mass

Mammary duct ectasia

Unilateral or often bilateral bloody (or guaiac-positive), serosanguinous, or multicolored (purulent, gray, or milky) discharge

Evaluation as for breast mass

Fibrocystic changes

A mass, often rubbery and tender, usually in premenopausal women

Possibly a serous, green, or white discharge

Possibly a history of other masses

Evaluation as for breast mass

Abscess or infection

Acute onset with pain, tenderness, or erythema

Often fever

With abscess, a tender mass and possibly purulent discharge

Clinical evaluation

If discharge does not resolve with treatment, evaluation as for breast mass

Breast cancer

Most often, intraductal carcinoma or invasive ductal carcinoma

May have a palpable mass, skin changes, or lymphadenopathy

Sometimes bloody or guaiac-positive discharge

If breast cancer is suspected, evaluation as for breast mass

Hyperprolactinemia

Many causes (eg, pituitary tumor, hypothyroidism, certain drugs—see table Causes of Hyperprolactinemia)

Often bilateral, milky nonbloody discharge with multiple ducts involved and no masses

Possibly menstrual irregularities or amenorrhea

If a pituitary lesion is the cause, possibly signs of CNS mass (visual field changes, headache) or other endocrinopathy

Prolactin level, TSH, review of drug use

If prolactin or TSH is elevated, MRI of head