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Monday, October 28, 2013

Yellow and Sticky Breast Discharge

Sticky, Icky, and perhaps a bit yellow or brownish or tending to a bit greenish is what women say about the discharge of their breasts that is the most common discharge that they report that is not a milk discharge.. When my patient's describe their physical complaints, we encourage being as accurate as possible. When we describe the consistency to others in the medical field, in fact, those same lay terms just creep right back into our lingo. But Dr. Nigel Bundred of Manchester in his recent writings on the subject of breast was reaching back into those 18th century metaphors when he described the discharge of Periductal Mastitis and Duct Ectasia as "toothpaste like". I did get the reference being both a avid student of the Two Fat Ladies  and all their British humor.. As it was in one very popular 18th Century recipe for toothpaste were the ingredients of burnt bread. But lets not digress. If you have this sticky yellow discharge, what could it mean? With or without breast tenderness. It might mean fibrocystic condition, it might mean milk production, it might mean inflammatory cancer brewing, but most likely it's this condition of aging due to stagnating ductal discharge and low grade inflammation of the breast that produces the odd coloration of the stuff. For some reason the inflammation usually is more marked around the ducts and flares up episodically. It's incidence is most likely during the ages of peak fertility: that late teen to mid 40s. It is no more or less common if you ever have been pregnant and or have ever breastfed; and physicians used to think it was a sterile condition and it wouldn't be possible to culture bacteria from the fluid. Apparently more cases are being linked to bacteria. Smokers are more likely to get these conditions and whether periductal mastitis and duct ectasia are identical or separate diseases is still being completely worked out, but they probably are a bit different. Tests that can be revealing of the nature of nipple discharge include: smears for precancerous cells, tests of blood, and tests for the presence of fat. Whether the nipple discharge is spontaneous or expressed is important to your physician, and whether the nipple has changed it's appearance or character may be important as well. Presences or absence of lumps are important as well. For more on breast disease check the NIH site. for sure, see your gyno if you have a breast discharge!

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