Nipple discharge is a common occurence, particularly in pre-menopausal women. Most nipple discharge is benign (non-cancerous) and occurs in multiple openings from both nipples. This type of discharge is usually cloudy, yellowish or brown in color and consisting of normal excess fluid within the milk ducts.
Discharge that is bloody or clear, arises from one nipple opening, and is spontaneous (comes out without the nipple being squeezed) may be caused by a growth within the affected milk duct. Most commonly, this growth is due to a benign tumor called a papilloma. Less frequently (in 10-13% of patients) the cause is a malignant growth. If nipple discharge fits the above criteria, further evaluation is indicated, beginning with a mammorgram and ultrasound. In addition a galactogram may also be indicated.
A galactogram is a study performed by the radiologist to evaluate the inside of the involved milk duct. A small cannula (blunt-non-sharp device) is inserted into the duct that produces discharge. An x-ray contrast material is then injected into the duct and mammographic images are obtained. If a mass is evident within the duct, subsequent surgical incision is indicated.