Management of nipple discharge and the associated imaging findings

Am J Med. 2015 Apr;128(4):353-60. doi: 10.1016/j.amjmed.2014.09.031. Epub 2014 Oct 17.


Nipple discharge is commonly encountered by health care providers, accounting for 2%-5% of medical visits by women. Because nipple discharge is the presenting symptom in 5% to 12% of breast cancers, it causes considerable anxiety for both patient and providers. Furthermore, the work-up and management of nipple discharge can be confusing. Fortunately, the cause of nipple discharge is usually benign, so the primary goal of evaluation and management is separation of patients with pathologic causes of discharge from those with benign or physiologic causes. The evaluation of nipple discharge requires a thorough history, careful physical examination, and an informed approach that selects the most suitable diagnostic modality. Primary care providers, working with their radiologists and surgeons, are well positioned to design appropriate diagnostic and management protocols to assess and treat nipple discharge. A thoughtful and prudent approach to nipple discharge should alleviate patient anxiety by efficiently and effectively defining the underlying etiology.

Keywords: Bloody nipple discharge; Breast cancer; Intraductal mass; Nipple discharge; Papilloma.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Breast / pathology*
  • Breast / physiology
  • Breast / physiopathology*
  • Breast Diseases / diagnosis*
  • Breast Diseases / pathology
  • Breast Diseases / physiopathology
  • Breast Neoplasms / diagnosis
  • Carcinoma, Ductal, Breast / diagnosis
  • Diagnosis, Differential
  • Disease Management
  • Exudates and Transudates*
  • Female
  • Galactorrhea / diagnosis
  • Galactorrhea / etiology*
  • Humans
  • Lactation
  • Magnetic Resonance Imaging
  • Mammography
  • Multimodal Imaging / methods*
  • Nipples*
  • Physical Examination
  • Physicians, Primary Care
  • Pregnancy
  • Primary Health Care / standards*
  • Ultrasonography, Mammary