What could be causing the changes in my breast and nipple discharge?

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Last updated: March 27, 2025 • View editorial policy

Differential Diagnosis for Breast Changes and Nipple Discharge

  • Single most likely diagnosis: + Benign nipple discharge: This is often caused by a hormonal imbalance or a benign growth, such as a fibroadenoma or intraductal papilloma. The discharge can be milky, bloody, or serous, and may be accompanied by breast tenderness or lumpiness.
  • Other Likely diagnoses: + Fibrocystic changes: These are common, benign changes in the breast tissue that can cause lumps, tenderness, and nipple discharge. They are often related to hormonal fluctuations during the menstrual cycle. + Intraductal papilloma: A small, benign growth in the milk ducts of the breast that can cause nipple discharge, often bloody. + Breast cyst: A fluid-filled sac in the breast that can cause lumpiness and nipple discharge.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.): + Breast cancer: Although less likely, breast cancer can cause changes in the breast, including nipple discharge, and must be ruled out with imaging and biopsy if necessary. + Pituitary tumor: A tumor in the pituitary gland can cause hormonal imbalances, leading to nipple discharge and breast changes.
  • Rare diagnoses: + Thyroid disorders: Certain thyroid conditions, such as hyperthyroidism, can cause nipple discharge and breast changes. + Endometriosis: A condition in which tissue similar to the lining of the uterus grows outside the uterus, can cause nipple discharge and breast changes, although this is rare. + Galactorrhea: A condition characterized by spontaneous milk production, often caused by a hormonal imbalance, can cause nipple discharge and breast changes.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.