Nipple problems

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

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

Treatment of nipple discharge caused by conditions outside of the breast include:

• Treatment for breast infections, hypothyroidism, and pituitary tumors
• Changing any medications that caused the discharge

Abnormal findings on a mammogram or breast ultrasound will be biopsied and often removed.

Most women with breast discharge who have a normal mammogram, breast ultrasound, and physical exam can be followed safely over 1 - 2 years with a mammogram and physical exam repeated during that time.

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Removing all or some of the breast ducts (called subareolar duct excision) may be done right away, or after a period of observation. Often a ductogram is done before surgery.

Steroid creams, antifungal creams, and antibiotic creams may be used to treat skin changes around the nipple.

For information on breast and nipple care while breastfeeding, see:

• Overcoming breastfeeding problems
• Breastfeeding tips
• Breastfeeding mothers - self-care

Most women with inverted nipples who give birth are able to breastfeed without complications.

In most cases nipple problems do not involve breast cancer. These problems will either go away with the right treatment, or they can be watched closely over time.

Nipple discharge may be a symptom of breast cancer or a pituitary tumor.

Skin changes around the nipple may be caused by Paget's disease.

Call for an appointment with your health care provider if:

• Your nipple becomes retracted or pulled in when it was not that way before
• Your nipple has changed in shape
• Your nipple becomes tender and it is not related to your menstrual cycle
• Your nipple has skin changes
• You have new nipple discharge

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).