Nipple discharge is a normal part of breast function during pregnancy or breast-feeding. It also may be associated with menstrual hormone changes and fibrocystic changes. The milky discharge after breast-feeding will normally affect both breasts and can continue for up to two or three years after stopping nursing.

A papilloma is a noncancerous (benign) tumor that can be associated with bloody discharge. It appears spontaneously and involves a single duct. Although the bloody discharge may resolve on its own, this situation requires evaluation with an ultrasound of the area behind the nipple and areola. If the ultrasound shows a lesion within a milk duct, you may need a biopsy to confirm that it's a papilloma or to exclude a cancer.

Often, nipple discharge stems from a benign condition. However, breast cancer is a possibility, especially if:

• You have a lump in your breast
• Only one breast is affected
• The discharge contains blood
• The discharge is spontaneous and persistent
• The discharge affects only a single duct

Possible causes of nipple discharge include:

1. Abscess
2. Birth control pills
3. Breast cancer
4. Ductal carcinoma in situ (DCIS)
5. Endocrine disorders
6. Excessive breast stimulation
7. Fibrocystic breasts (lumpy or rope-like breast tissue)
8. Galactorrhea
9. Injury or trauma to the breast
10. Intraductal papilloma (a benign, wartlike growth in a milk duct)
11. Mammary duct ectasia
12. Mastitis (an infection in breast tissue that most commonly affects women who are breast-feeding)
13. Medication use
14. Menstrual cycle hormone changes
15. Paget's disease of the breast
16. Periductal mastitis
17. Pregnancy and breast-feeding
18. Prolactinoma

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Jan. 11, 2018