Nipple discharge

With Dr Mary Ling, Central Coast Breast and General Surgeon

Nipple discharge is when fluid leaks from the nipple. It is a common breast symptom. Here are answers to 4 frequently asked questions.

1What are the features of nipple discharge to look out for? Nipple discharge can be ƒ Spontaneous (fluid leaks without any squeezing of the nipple) or on expression (fluid comes out only when the nipple is squeezed) ƒ Unilateral (from one breast) or bilateral (from both breasts) ƒ Sin gle duct (from one opening on the nipple) or multiple ducts (from more than one opening on the nipple) ƒ Blo od-stained, clear, green, milky or yellow in colour

2Can nipple discharge be normal?

Yes. Fluid can be obtained from the nipples of around 70% of women when special techniques, massage or devices (e.g. breast pumps) are used. This discharge of fluid from a normal breast is called ‘physiological discharge’.

Physiological discharge is typically on expression (rather than spontaneous), comes from multiple ducts and yellow, milky or green in colour.

Physiological discharge requires no treatment. It is important to stop expressing or squeezing the nipple and breast, as this causes more fluid to be made. The discharge will usually stop when you stop expressing.

3When is nipple discharge abnormal?

Spontaneous nipple discharge unrelated to pregnancy or breastfeeding is abnormal.

There are many causes of abnormal nipple discharge, including ƒ Duct ectasia: a benign condition in which there is enlargement & inflammation of the milk ducts under the nipple

ƒ Duct papilloma: a growth within the milk duct near the nipple ƒ Nipple eczema: dermatitis affecting the skin of the nipple ƒ Paget’s disease of the nipple: a type of breast cancer involving the nipple ƒ Bre ast cancer

Nipple discharge that is spontaneous, blood-stained, persistent and unrelated to pregnancy or breastfeeding requires clinical assessment by your doctor and imaging of the br easts with ultrasound and mammogram (and s ometimes MRI).

4Will I need surgery?

Surgery for nipple discharge is required for ƒ D iagnosis of blood-stained nipple discharge even if imaging shows no abnormality (as changes behind the

Nipple discharge associated with other symptoms such as a lump or skin changes always requires investigation.

nipple can be difficult to see) ƒ Treatment of the underlying disease (e.g. papilloma, breast cancer) ƒ Treatment of annoying discharge caused by benign conditions (e.g. duct ectasia)

Dr Mary Ling is a Breast and General Surgeon who consults at Gosford, Woy Woy and Kanwal.

*This advice is general only. All surgical procedures have risks. Speak to your doctor about your symptoms

Erina Fair launches initiative to combat waste

To help combat the growing mountain of takeaway coffee cups ending up in landfill, Erina Fair Shopping Centre announced a partnership with Closed Loop, to recycle disposable cups used in the Centre.

As part of Closed Loop’s Simply Cups Program, Erina Fair Shopping Centre is introducing five coffee cup recycling bins throughout the Centre and will be encouraging customers to recycle. The bins are shaped as coffee cups.

Australians use more than one billion disposable coffee cups each year. The cups are estimated to be the secondlargest contributor to litter waste, after plastic bottles.

Most takeaway coffee cups end up in landfill, as the plastic lining in the cups cannot be processed in traditional recycling facilities. The plastic lining will take over 50 years to break down in landfill, and when disposed of incorrectly in a comingled or paper recycling bin, the entire bin contents are considered contaminated and sent to landfill.

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