Differential Diagnosis for Nipple Pain and Spotting
- Single most likely diagnosis
- Breast cyst or fibrocystic changes: These are common benign conditions that can cause nipple pain and spotting due to hormonal fluctuations.
- Other Likely diagnoses
- Ductal ectasia: A condition where the milk ducts in the breast become widened, leading to nipple discharge, pain, and sometimes spotting.
- Intraductal papilloma: A small, benign tumor that grows in the milk ducts of the breast, often causing nipple discharge, which may be bloody, and pain.
- Breast infection or mastitis: An infection of the breast tissue, which can cause pain, swelling, and discharge, including spotting.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Breast cancer: Although less common, breast cancer can present with nipple pain and discharge, including spotting. It's crucial to rule out cancer, especially in older women or those with a family history.
- Paget's disease of the breast: A rare form of breast cancer that affects the skin of the nipple and, sometimes, the areola, causing eczema-like changes, pain, and discharge.
- Rare diagnoses
- Endometriosis of the breast: A rare condition where endometrial tissue grows outside the uterus, including in the breast, leading to cyclic pain and nipple discharge.
- Breast tuberculosis: A rare infection of the breast tissue, which can cause pain, swelling, and discharge, including spotting.