Differential Diagnosis for Discharge from Breast
- Single most likely diagnosis
- Galactorrhea: This condition is characterized by the spontaneous flow of milk from the breast, not associated with childbirth or nursing. It's often caused by hormonal imbalances, particularly prolactin, and is a common cause of breast discharge.
- Other Likely diagnoses
- Ductal ectasia: A condition where the milk ducts in the breast become widened, leading to discharge. It's more common in older women and can be associated with periductal mastitis.
- Intraductal papilloma: A small, benign tumor that grows in the milk ducts of the breast. It can cause discharge, often bloody, from a single duct.
- Breast infection or abscess: An infection of the breast tissue can cause discharge, especially if an abscess forms. This is more common in lactating women but can occur in anyone.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Breast cancer: Although less common, breast cancer can cause discharge, especially if it involves the ducts. It's crucial to investigate any discharge, especially if it's bloody, unilateral, or from a single duct.
- Pituitary tumor: A tumor in the pituitary gland can lead to an overproduction of prolactin, causing galactorrhea. While rare, missing a pituitary tumor could have significant health implications.
- Rare diagnoses
- Thyroid disorders: Both hyperthyroidism and hypothyroidism can lead to changes in hormone levels that might result in breast discharge, though this is less common.
- Neurogenic causes: Certain conditions affecting the nervous system can influence hormone production, potentially leading to breast discharge.
- Medication-induced galactorrhea: Certain medications can cause an increase in prolactin levels, leading to galactorrhea. This is a rare cause but should be considered, especially if the patient is on medications known to affect prolactin levels.