Assessment
Questionnaire
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a doctor would ask.
See what questions
a doctor would ask.
During a consultation, your doctor will use various techniques to assess the symptom: Nipple discharge. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.
It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.
Create your printable checklist by answering questions that your doctor may ask below:
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Why: to establish if acute or chronic.
Why: e.g. bloody, watery, milky, green, yellow or pus-like.
Why: if unilateral and watery or bloody discharge consider breast cancer, intraduct papilloma, Paget's disease, papillary cystadenoma or epithelioma of the nipple. If bilateral and milky should consider the various conditions that cause hyperprolactinemia (elevated prolactin hormone in the blood) or pregnancy. A bilateral bloody discharge suggests mammary dysplasia (chronic cystic mastitis).
Why: suggests benign mammary dysplasia (before the menstrual period) or due to oral contraceptive pill (more evident just before the menstrual period).
Why: an obvious reason for bilateral milky nipple discharge.
Why: e.g. sexual stimulation, mammograms, poorly fitting bra and tight clothes - may cause a small nipple discharge.
Why: this will help determine the cause of nipple discharge. e.g. in premenopausal women, spontaneous multiple duct green or brownish discharge, unilateral or bilateral, most marked before menstruation, is often mammary dysplasia.
Why: e.g. age over 40 years, Caucasian race, pre-existing benign breast lumps, personal history of breast cancer, family history of breast cancer in a first degree relative, late menopause (after age 53), obesity, childless until after 30 years of age, early age of first menstrual period.
Why: increases the risk of breast cancer in the other breast and also of recurrent breast cancer in the same breast.10 % of people with a past history of breast cancer will develop breast cancer in the other breast.
Why: e.g. causes of elevated prolactin hormone levels include pituitary tumor, sarcoidosis, hypothyroidism, renal failure and liver failure.
Why: e.g. some medications cause an elevated prolactin hormone level and milky nipple discharge such as oral contraceptives, phenothiazines, hormone replacement therapy, certain blood pressure medications, certain antidepressants, certain sedatives and Methyldopa.
Why: increases the risk of breast cancer threefold.
Why: a focal mass in the breast with a bloody discharge makes a breast cancer almost certain. If there is a focal mass, fever and a non-bloody discharge should consider a breast abscess. Mammary dysplasia can cause breast nodularity and sometimes a discrete lump but this varies with the menstrual period and usually causes multiple or bilateral masses.
Why: a bloody discharge associated with breast pain suggests breast cancer if unilateral; mammary dysplasia if bilateral (causes discomfort particularly before the menstrual period and settles after the period).
Why: suggests Mammary dysplasia.
Why: fever or chills along with a pus-like discharge from the breast is most likely acute mastitis or a breast abscess.
Why: e.g. breast lump, usually painless ( only 5% associated with pain), lump is hard and irregular. May have nipple discharge or nipple retraction. May have symptoms of metastases such as back pain, shortness of breath, weight loss or headache.
Why: e.g. back pain, shortness of breath, weight loss, and headache - may suggest breast cancer metastases.
Why: suggests Paget's disease of the breast.
Why: e.g. most common in women between 30 and 50 years of age. Unilateral or bilateral breast pain, tenderness, lumpiness and swelling, especially prior to the menstrual period. Symptoms usually settle after the menstrual period. May have a nipple discharge which can be various colors, mainly green-grey.
Why: e.g. an entire breast quadrant may be hard and tender. A firm, tender, poorly defined lump may be felt near the margin of the areola (red part of breast surrounding the nipple). There may be a toothpaste -like nipple discharge.
Why: e.g. headache, visual field loss, menstrual disturbance, reduced fertility, bilateral milky nipple discharge.
Why: e.g. missed menstrual periods, breast enlargement, breast tenderness, urinary frequency. Pregnant women may experience a milky discharge from the nipples due to an elevated level of prolactin.
The following list of conditions have 'Nipple discharge' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.
Select from the following alphabetical view of conditions which include a symptom of Nipple discharge or choose View All.
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Copyright © 2011 Health Grades Inc. All rights reserved. Last Update: 7 May, 2013 (4:19)
