Hormones 2016

Breast disorders
Nipple discharge can be serous 98 (yellow), mucinous 99 (clear and watery),
milky, sanguineous 100 (bloody), purulent 101 , multicolored and sticky, or
serosanguineous 102 (pink). It may occur spontaneously or only in response
to breast manipulation (Kosir, 2013b).
Pathophysiology
103 Nipple discharge may be breast milk or an exudate produced by a
number of conditions.
Breast milk production in nonpregnant and nonlactating women (galactorrhea)
typically involves an elevated prolactin level, which stimulates
glandular tissue of the breast. However, only some patients with elevated
prolactin levels develop galactorrhea.
Causes
Most frequently, nipple discharge has a benign cause, see Some Causes
of Nipple Discharge. Cancer (usually intraductal carcinoma or invasive
ductal carcinoma) causes < 10% of cases. The rest result from benign ductal
disorders (eg, intraductal papilloma, mammary duct ectasia, fibrocystic
changes), endocrine disorders, or breast abscesses or infections. Of these
causes, intraductal papilloma is probably the most common; it is also the
most common cause of a bloody nipple discharge without a breast mass.
Endocrine causes involve elevation of prolactin levels, which has numerous
causes.
Causes
Several disorders can cause an abnormal discharge. A discharge from one
milk duct or from one breast is likely to be caused by a problem with that
breast, such as a noncancerous or cancerous breast tumour. A discharge
from both breasts or from several milk ducts in one breast is more likely to
be caused by a problem outside the breast, such as a hormonal disorder or
use of certain drugs.
98 producing or containing serum
99 relating to, resembling or containing mucin
100 containing blood
101 containing, discharging, or causing the production of pus
102 composed of serum and blood
103 The physiological processes associated with disease or injury
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