Nipple problems

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Abnormal discharge from the nipple	Female breast	Intraductal papilloma	Mammary gland
Normal female breast anatomy

Nipple problems can include tenderness, skin changes, changes in shape, or discharge from the nipple portion of the breast.

This article is about nipple problems or changes in women who are not breastfeeding or who have not just had a baby (postpartum).

Discharge from breasts; Milk secretions; Lactation - abnormal; Witch's milk; Galactorrhea; Inverted nipple; Nipple discharge

Nipple tenderness or skin changes may be caused by:

• Bacterial or fungal infections
• Dry skin in the areolar region (the darker area surrounding the nipple) of the breast
• Injury to or friction over the nipple area
• Paget's disease

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The likelihood of nipple discharge increases with age. It is somewhat common in women who have had at least one pregnancy or are in the final weeks of pregnancy.

A milky nipple discharge is rare in men or women, but it does occur. When it occurs in men or in women who have never been pregnant, it is likely to be caused by an underlying disease. However, even then nipple discharge has many other causes that are NOT breast cancer, including:

• A tumor in the brain called a prolactinoma or microadenoma
• A small, noncancerous growth in the breast called an intraductal papilloma
• Breast abscess located underneath the areola (most commonly seen in women during breastfeeding)
• Injury to the breast or chest wall (milky discharge)
• Pregnancy, usually during the second trimester
• Severe hypothyroidism
• Use of certain drugs, including birth control pills, cimetidine, methyldopa, metoclopramide, phenothiazines, reserpine, tricyclic antidepressants, or verapamil
• Widening of the milk ducts (called ductal ectasia), normally not a cancerous problem
• "Witch's milk," a term used to describe nipple discharge in a newborn. The discharge is a response to hormones from the mother before birth, and should disappear within 2 weeks.

Nipple inversion is a condition that you are born with. Nipple retraction may be caused by aging, duct ectasia, infections in the milk duct, or breast cancer.

Review Date: 11/01/2009
Reviewed By: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, WA; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).