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DIFFERENTIAL DIAGNOSIS OF DISCHARGE FROM THE NIPPLE

  • BLOOD STAINED DISCHARGE: It can be caused by
  1. Paget’s disease
  2. Duct papilloma especially if discharge is from the duct, usually single duct: Ductography/ ductogram is indicated.
  3. Breast cancer
  • CLEAR DISCHARGE: It is caused by intraductal papilloma ( discharge from the duct and should be investigated by Ductography or Ductogram.
  • ORANGE, YELLOW CREAMY, GREEN DISCHARGE : It is caused by discharge from multiple ducts ( Duct ectasia) and should be investigated by Ductogram.
  • PURULENT DISCHARGE: It is caused by breast abscess and is common is breast feeding mother. The causative organism is staphylococcal aureus. It should be treated by Flucloxacillin.
  • MILKY DISCHARGE: It is caused by:
  1. Prolactinoma: level of prolactin is >1000 units
  2. Side effects of Anti- psychotics
  3. Physiological: lactating mother
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