Differential Diagnosis for Nipple Bumps with Discharge

Single Most Likely Diagnosis

• Intraductal Papilloma: This is the most common cause of a nipple bump with discharge. It is a small, benign tumor that grows in the milk ducts of the breast. The discharge is often bloody or serous and comes from a single duct.

Other Likely Diagnoses

• Duct Ectasia: A condition where the milk ducts beneath the nipple become widened, leading to a thick, sticky discharge. It's more common in older women and can cause nipple retraction.
• Periductal Mastitis: Inflammation of the tissue around the milk ducts, which can cause a bump and discharge. It's often associated with smoking.
• Breast Abscess: A collection of pus in the breast tissue, which can cause a bump, pain, and discharge. It's more common in lactating women but can occur in anyone.

Do Not Miss Diagnoses

• Breast Cancer: Although less common, breast cancer can present with a nipple bump and discharge. It's crucial to rule out cancer, especially if there's a new lump, skin changes, or a family history of breast cancer.
• Paget's Disease of the Breast: A rare form of breast cancer that affects the skin of the nipple and, sometimes, the areola. It can cause a nipple bump, discharge, and skin changes like redness and scaling.

Rare Diagnoses

• Nipple Adenoma: A rare, benign tumor of the nipple that can cause a bump and discharge.
• Syphilis: A sexually transmitted infection that can cause a painless bump or ulcer on the nipple, along with discharge, in its secondary stage.
• Tuberculosis of the Breast: A rare condition where tuberculosis infects the breast tissue, which can cause a bump, discharge, and other systemic symptoms like fever and weight loss.