Nipple Discharge Treatment Birmingham

Nipple discharge can be a concerning symptom, and while it is often related to a harmless condition, it is always important to have it checked by a specialist. The fluid can vary in colour and consistency, and it can be spontaneous or occur only when the breast is squeezed. The cause is usually benign, but a consultation with a breast specialist is the best way to get an accurate diagnosis and a clear treatment plan. Mr Jamie Vatish offers the nipple discharge treatment Birmingham patients seek at two private hospitals.

Understanding the causes of nipple discharge

The causes of nipple discharge are numerous and can be categorised as either physiological or pathological. Physiological discharge is often considered a normal function of the breast, and it usually appears milky, clear, yellow, or brown. Hormonal changes during the menstrual cycle, pregnancy, or breastfeeding may link to it. Other common causes include:

Duct ectasia: This is a non-cancerous condition where the milk ducts under the nipple widen and can become inflamed. It is most common in perimenopausal women and can lead to a sticky, multicoloured discharge.
Intraductal papilloma: A small, wart-like growth inside a milk duct. It is a benign tumour and is the most common cause of a bloody or clear discharge from a single duct.
Fibrocystic breasts: Common, non-cancerous changes in breast tissue.
Hormonal imbalances: A discharge can be caused by the abnormal production of a hormone called prolactin, often due to medication, an underactive thyroid, or a benign tumour in the pituitary gland.
Medication: Certain medicines, including some antidepressants and birth control pills, can stimulate the pituitary gland to release prolactin and cause discharge.
Breast infection (mastitis): This can cause a pus-like discharge, often accompanied by redness and swelling of the breast.

While breast cancer is a rare cause, you should always investigate nipple discharge, especially if it is:

Bloody or pink.
Spontaneous and persistent, without squeezing.
Comes from only one breast.
Accompanied by a lump or skin changes.
Occurs in a male.

Diagnosis and treatment options

Your breast specialist will begin by taking a detailed medical history and performing a clinical examination. They may gently apply pressure to the breast to try and express some fluid for a sample. Further diagnostic tests can include:

Mammogram or ultrasound: Doctors use these imaging tests to look for any abnormalities in the breast tissue. An ultrasound is typically the initial imaging modality for women under 40.
Blood tests: These can measure hormone levels, such as prolactin and thyroid hormones, to check for a systemic cause.
Biopsy: If a lump or suspicious area is found on imaging, a doctor may take a tissue sample for further testing.
Ductogram: In some cases, a doctor uses a small catheter to inject a contrast agent into the affected milk duct, followed by a mammogram, to get a detailed image of the ductal system.

Treatment for nipple discharge

The treatment for nipple discharge depends entirely on the underlying cause. If the discharge is physiological and benign, a specialist may advise you to simply stop expressing the fluid, as this can make the issue worse. For other causes, a doctor can recommend treatment:

Medication changes: If the discharge is a side effect of a medicine you are taking, a doctor may advise a change in prescription.
Medication: Doctors use antibiotics to treat breast infections.
Surgery: Surgical intervention may be necessary in some cases, particularly for conditions like intraductal papilloma or duct ectasia. This procedure, called microdochectomy, involves the removal of a single affected duct.
Managing systemic conditions: If the cause is an underactive thyroid or a pituitary tumour, treating that condition will resolve the discharge.