Gynecology

Question:

You are CORRECT!!

The most common cause of nipple discharge in a nonlactating woman is fibrocystic change with ectasia of the ducts. Nipple discharge associated with fibrocystic change can be unilateral or bilateral, most marked just before menstruation and may be green or brownish. (48)

Milky discharge from multiple ducts in nonlactating women presumable reflects increased secretion of pituitary prolactin. Accordingly, prolactin and thyroid stimulating hormone levels should be checked. Phenothiazines may also cause milky discharge that disappears when medication is discontinued.

Oral contraceptive agents may cause clear, serous, or milky discharge from multiple ducts. Other causes include intraductal papilloma, prolactinoma and carcinoma. The presence of bloody discharge, a palpable mass and postmenopausal status all increase the likelihood of cancer.

References:

48. Berek JS AE, Hillard PA: Novak's Gynecology, 12th ed. Baltimore, Maryland: Williams and Wilkins, 1996.

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