A common symptom of patients visiting the breast surgery department for breast problems is ‘discharged nipples’. Nipple discharge is known as one of the three most common breast symptoms along with mastalgia and mass. In more than 80% of women, it is a physiological phenomenon caused by hormones and can appear temporarily without any specific cause. However, it can be an abnormal signal due to breast cancer or various breast diseases, so it is good to have a detailed examination to determine the cause correctly.
Nipple discharge can be caused by hormonal changes during childbirth or breastfeeding, and external stimulation or excessive pressure, such as wearing tight underwear, can also cause nipple discharge. Or, it can also occur under the influence of different types of drugs, such as birth control pills, female hormone therapy for postmenopausal women, stomach medications, sedatives, and sleeping pills.
In case of a pituitary adenoma, a prolactin level test is required. At this time, if the prolactin level is 100ng/ml, it is necessary to check whether it is a benign tumor, prolactinoma, through a brain MRI.
The most common cause of pathological papillary secretion is intraductal papilloma. Although the lesion is classified as benign, confirmation by resection is recommended as it may be accompanied by dysplasia or ductal carcinoma in situ.
Galactorrhea due to benign breast disease, such as ductal ectasia, is when discharge is mixed in color, such as green or gray, and the cause can be identified by tests. On the other hand, if the secretion comes out on its own even though the nipple is not stimulated, or if bloody secretions come out of one nipple in one breast, breast cancer should be suspected. .
Symptoms of nipple discharge from benign breast disease and pathological breast disease are different. In the case of benign breast disease, it is mainly bilateral, and is secreted from several milk ducts and secreted when squeezed. On the other hand, in the case of malignant breast disease △ occurs on one side only △ occurs in a single milk duct △ occurs spontaneously or occurs together with blood or serous blood or a nodule △ occurs in a woman over 40 age, the risk of breast cancer increases In this case, it must be confirmed by breast cancer screening.
Written = Director Lee Joo-hyun, medical reporter in Haidak (surgeon)
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