Differential Diagnosis for Intermittent Nipple Discharge
- Single Most Likely Diagnosis
- Intraductal Papilloma: This is the most likely diagnosis given the presentation of spontaneous, serosanguineous nipple discharge from a single breast. Intraductal papillomas are small, benign tumors that grow in the milk ducts of the breast and are a common cause of nipple discharge, especially when it is bloody or serosanguineous.
- Other Likely Diagnoses
- Ductal Ectasia: This condition involves the widening of a milk duct in the breast, which can cause nipple discharge. It is more common in older women and can present with a variety of discharge colors, including serosanguineous.
- Breast Cysts or Fibroadenomas: While these conditions are more commonly associated with palpable masses, they can occasionally cause nipple discharge, especially if they are large or located near the nipple.
- Do Not Miss Diagnoses
- Breast Cancer (Ductal Carcinoma In Situ or Invasive): Although less likely, breast cancer must be considered in the differential diagnosis of nipple discharge, especially if it is bloody or serosanguineous. It is crucial to rule out cancer due to its significant implications for treatment and prognosis.
- Pituitary Tumor (Prolactinoma): A prolactinoma can cause galactorrhea (milk production not associated with childbirth or nursing), which might be mistaken for nipple discharge. This condition is important to identify due to its potential effects on hormone levels and vision.
- Rare Diagnoses
- Breast Hemangioma: A benign vascular tumor that could potentially cause bloody nipple discharge, although this is very rare.
- Tuberculosis of the Breast: This is a rare condition in many parts of the world but can cause a variety of breast symptoms, including nipple discharge. It is more likely to be considered in areas where tuberculosis is common or in individuals with a history of tuberculosis exposure.