Nipple Discharge
Nipple discharge is a symptom experienced by approximately 80% of women of reproductive age at certain periods of life and can be evaluated as normal or abnormal according to the characteristic features of the discharge. The discharge may be due to the drugs that the person has used, an infection or a cancer disease involving the breast tissue, or it may be completely physiological and harmless. It is extremely important for all women of reproductive age to have information about nipple discharge, to distinguish between inflammation and similar signs of infection in the nipple, and to recognize possible cancer at an early stage. It may also be yellow-gray in color, greenish, milky, inflammatory, and blurry in appearance. In middle-aged women, when the brown tip of the breast, called the areola, is squeezed, gray discharges can be removed, but nipple discharges that are removed by force are usually not considered pathological and do not indicate a disease. However, all the discharges seen in the breast should be examined in detail and the underlying disease, if any, should be determined.
What Causes Breast Discharge?
In some cases, nipple discharge may occur due to a purely physiological and natural reason, or it may develop due to serious diseases such as mastitis, papilloma or cancer. In order to determine the main factor causing the discharge, it is necessary to review in detail many features such as the color, consistency, frequency of the discharge, whether it is unilateral or not, whether it occurs by squeezing or spontaneously.
- Physiological nipple discharge is a completely natural process. It usually occurs during pregnancy and may recur intermittently for about 2 years after birth. Bloody nipple discharge is rarely seen in pregnant women and nursing mothers. It is caused by excessive blooding of the nipple and milk ducts due to pregnancy hormones. However, if this situation persists or recurs frequently, it must be evaluated by a breast surgeon. It can be caused by disorders in other organs. Tumors affecting the area of the brain called the pituitary gland, hypothyroid disease, which can be defined as the thyroid gland working less than normal, cancers involving the respiratory tract or lung tissue, and some disorders affecting the hypothalamus area of the brain can cause nipple discharge.
- Some drugs can cause spontaneous milk secretion from both breast tissues. In psychiatry, antipsychotic group drugs used in the treatment of psychoses such as schizophrenia, gastric acid regulators called H2 receptor blockers, antihypertensives used in the treatment of high blood pressure, antiemetics used as anti-nausea, oral contraceptives used for birth control and drugs used in the treatment of some neurological diseases spontaneously from both breasts. milky discharge may occur.
- Pathologically grouped nipple discharges may occur as a result of benign diseases such as intraductal papilloma, ductal hyperplasia, ductal ectasia, plasma cell mastitis and chronic mastitis, as well as due to breast cancer. Intraductal papilloma is the appearance of benign tumors in the milk ducts, usually just behind the brown part of the breast called the areola. It occurs with discharge and pain in the breast and is usually seen in women over 35 years of age. Ductal hyperplasia is defined as the overgrowth of the cells forming these ducts in the breast tissue, and this picture often causes nipple discharge. In addition, excessive enlargement of the ducts in the breast can lead to discharge from the nipple. This condition, which is called ductal ectasia, is a cause of discharge as high as 15%. Finally, inflammatory breast lesions called mastitis are among the rare causes of nipple discharge. All these diseases are pathological conditions that occur in the breast tissue and the nipple discharges that occur in these cases should be followed closely.
- Breast cancer is the most common type of cancer in women, and nipple discharge is one of the common symptoms of this cancer. Discharge due to breast cancer is most likely bloody It is in nature and usually occurs from a single breast, usually from a single channel and spontaneously.
How to Treat Nipple Discharge?
A breast surgeon should see all kinds of breast diseases first. Treatment of nipple discharge begins with a detailed history of the patient and a comprehensive breast examination. First of all, it is decided whether the nipple discharge is pathological or not. Depending on the patient's age, current condition or examination findings, further examination with mammography and/or ultrasonography may be required. Some patients may require a breast MRI. Especially in women over the age of 40 and men of all ages, nipple discharge should be carefully examined. Biopsy may be required after physical examination and radiological examinations. Surgical intervention may be considered in pathological nipple discharges. It may be necessary to remove a single duct or all ducts behind the nipple. If nipple discharge is due to breast cancer, the necessary treatment for breast cancer is applied.
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