Thom said:
another thing.. shouldn't the fluid be white? cause he tells me it's like water...
No, it's not what you may think of as white milk:
Milky discharge (cloudy, whitish or almost clear in color, thin, non-sticky) is the most common type of discharge. Most milky discharge is caused by lactation and / or increased mechanical stimulation of the nipple. Drugs or hormones that stimulate prolactin secretion can cause spontaneous, persistent production of milk (galactorrhea). Prolactin is the hormone produced by the pituitary gland that starts the growth of the mammary glands and triggers production of milk. Some pituitary tumors cause excess prolactin secretion that can lead to milky nipple discharge, usually from both breasts (bilateral). Opalescent discharge that is yellow or green in color is normal.
Most bloody or watery (serous) nipple discharge (approximately 90%) is due to a benign condition such as papilloma or infection. A papilloma is a non-cancerous, wart-like tumor with a branching or stalk that has grown inside the breast duct. Papillomas frequently involve the large milk ducts near the nipple. Multiple papillomas may also be found in the small breast ducts further from the nipple.
Of the benign conditions that cause suspicious nipple discharge, approximately half is due to papilloma and the other half is a mixture of benign conditions such as fibrocystic conditions or duct ectasia (widening and hardening of the duct due to age or damage). Most opalescent discharge is due to duct ectasia or cyst.
Suspicious nipple discharge is due to a malignant (cancerous) lesion just ten percent (10%) of the time. Discharge caused by a malignant condition is almost always on one side only (unilateral). Discharge that is coming from both breasts (bilateral) is usually benign. Papilloma usually causes discharge from a single breast duct.
Nipple Discharge in Men
Both male and female adolescents may experience a milky / clear (non sticky) discharge during puberty due to homronal fluctuations. Nipple discharge in the adult male should be examined by a physician or healthcare specialist to determine cause.
Examination for Nipple Discharge
A blood test of prolactin levels is often made to determine hormonal causes of excessive milky discharge (galactorrhea). A hormone imbalance, pituitary tumor, and certain drugs such as sedatives, tranquilizers, hormone replacement / anabolic steroids or birth control pills may cause excessive prolactin levels.
If there is a suspicious nipple discharge, an examination by a physician should be performed. Clinical breast exam (CBE) is first performed. If a discharge can be produced during the examination, some of the fluid may be collected and examined under a microscope to see if any blood cells or cancer cells are present. This test is called a nipple smear. The discharge may also be examined for signs of infection such as pus. Papillomas may be seen with microscopic examination of a nipple discharge, but this test may be inconclusive.
If the discharge is bloody or serous, a mammogram is often the first test to be performed. Even when no cancer cells are found in a nipple discharge, it is not possible to rule out breast cancer or other condition such as papilloma.
If a patient has a suspicious mass together with nipple discharge, evaluation of the mass should be performed using mammography, adjunctive imaging and biopsy as necessary. If these tests are negative and show no malignancy, nipple smear should be evaluated.
Some papillomas are near the nipple and are large enough to be felt. In these cases, a needle biopsy can be done to test for malignancy or diagnose papilloma.
In some cases, a galactogram (also called a ductogram) is performed to aid in diagnosing the cause of an abnormal nipple discharge such as intraductal papilloma. However, a ductogram that does not show an abnormality does not exclude the fact that a significant lesion may be present.
Treatment for Persistent Nipple Discharge
The standard treatment for nipple discharge that has no hormonal involvement is duct excision. Duct excision is usually performed on an outpatient basis with local anesthesia. The procedure is usually done through a small circular incision near the areolar border around the nipple. It is not uncommon for the pathology found to be so microscopic that it is invisible without the assistance of a microscope. Typically, nursing ability and nipple sensation are preserved after duct excision. Breast-feeding in the other breast should have no affect from the duct excision in the opposite breast.
The above information and statistics are general guidelines. If you have nipple discharge that is worrisome, please do not hesitate to contact your physician or healthcare provider about it. However, keep in mind that most nipple discharge is not caused by breast cancer.
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he agreed :\ I guess he didn't understand the irony over msn messenger.
