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.