I. Various traits: colored fluid overflowing from the opening of the milk ducts in the nipple.
Second, the diagnosis of nipple overflow: there are clinical manifestations of nipple overflow, combined with auxiliary examinations, ultrasound, ductoscopy, mammography, mammogram, magnetic resonance, puncture biopsy, etc.
Third, a variety of different causes of nipple overflow and treatment principles.
1.Physiological overflow
Most adult women can squeeze out a small amount of fluid through breast massage and light squeezing and suction, which is physiologically secreted. The color is diverse, the vast majority is colorless and transparent, milk-like, yellowish, and a few can be green, brown, and dark blue. Most of this physiologic overflow is multi-catheter. In this case, patients need not worry and do not need special treatment.
2.Pharmacological overflow
Taking certain drugs, such as the psychotropic drugs phenothiazine, haloperidol, etc., certain anti-hypertensive drugs such as methyldopa and reserpine, opiates, drugs containing estrogen, etc. This condition is also not a cause for concern and does not require treatment.
3. Intraductal papilloma
The most common cause of plasmacytic or bloody discharge, the tumors tend to occur in the larger subareolar ducts. Although some researchers believe that solitary papilloma should not be considered as precancerous lesion, surgery is still a necessary option and usually requires excision of the diseased duct or removal of microscopic nodules.
4.Multiple intraductal papillomas
Approximately 10% of intraductal papillomas are multiple, either multiple nodules in one duct or multiple nodules in multiple ducts, and studies have shown that multiple intraductal papillomas are associated with an increased risk of breast cancer. Surgery is necessary and usually requires ductal resection or mastectomy.
5.Breast cancer
Both invasive and non-invasive cancers can cause nipple discharge, but ductal carcinoma in situ is the most common, and it is very rare for invasive carcinoma to cause nipple discharge without detecting a breast lump. If nipple overflow is the first or main symptom and breast cancer is diagnosed in the adjuvant examination, it will be further treated according to the principles of breast cancer treatment.
6. Bloody nipple overflow during pregnancy
It is common to have nipple overflow containing blood during pregnancy or lactation. The possible reason is that there are too many blood vessels in the developing breast tissue during this period; this condition is benign and does not require special treatment.
7. Breast overflow (or breast overflow)
Bilateral milk-like overflow that is not related to pregnancy or breastfeeding is called overflow. A small amount of overflow, caused by squeezing, does not indicate a serious problem and can be observed. A large amount of overflow is often caused by elevated prolactin, and a significant increase in prolactin is a problem of medication, in addition to the possibility of pituitary prolactin microadenoma, which can be clarified by cranial magnetic resonance examination if necessary, but avoiding a small amount of overflow or squeezing caused by overflow of breast over MRI (MRI is still relatively expensive), pituitary prolactin microadenoma is not a serious problem, it is It is a small benign tumor that is not treated without symptoms and can be solved by a minor neurosurgical procedure when concomitant symptoms appear. The main drug treatment for hyperprolactinemia is oral bromocriptine.
8. Ductal Dilatation
Some women have nipple discharge due to ductal dilatation, which is mostly a colorless or yellowish fluid, but can also appear as a thick, toothpaste-like, or even cheese-like discharge. Dilated ducts generally do not require treatment, unless there is persistent overflow in larger amounts, causing significant inconvenience to life, and surgery can be considered, with a very minor procedure of overflowing nipple duct dissection and excision.
Fourth, nipple overflow is in most cases a benign manifestation
It is rare for malignant pathological reasons to cause overflow, so there is no need to worry about nipple overflow, go to a regular hospital breast specialist for a checkup and obey the doctor’s treatment advice.