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Cancers infrequently present as an isolated discharge.

The incidence of breast cancer associated to isolated nipple discharge ranges from .6% to 2%.

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Nipple discharge is the third most common complaint among women after breast pain or a breast mass.

Up to 50% of women in their reproductive years can express one or more drops of fluid from the breast. Nevertheless, it does raise the concern about two uncommon but serious conditions. Common Features: • Unilateral or bilateral discharge • Cycle variation • Induced or spontaneous discharge • Discharge may be clear, serous, milky, yellow, green, pink or slightly bloody, brown or black (old blood) • Discharge may originate from one or multiple ducts Normal/Benign Discharge: During pregnancy and up to two years after delivery nipple discharge is normal and milky in nature.

The presence of multiple papillomas is referred to as papillomatosis. Papillomas usually affect women from 35- 50 years of age. The papilloma usually involves a single duct and is present in one breast.

Although not considered a true precursor of cancer, women with papillomas may be at a slightly higher lifetime risk for carcinoma (5%).

This is due to the possibility of the coexistence of other proliferative lesions.

Ductal Ectasia: This is a condition characterized by the dilatation of major ducts and some degree of inflammation and fibrosis around the ducts.

Mammary secretions originate from these breast lobules.

It is important to differentiate between nipple discharge and secretion of the nipple.

The surgical treatment of spontaneous nipple discharge includes central duct exploration and excision.

A patient with nipple discharge should undergo evaluation by a breast specialist.

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