Differential Diagnosis for 29-year-old with Bloody Discharge in Left Nipple
- Single most likely diagnosis:
- Intraductal papilloma: This is the most common cause of bloody nipple discharge in women, especially when it's unilateral. It's a benign tumor that grows in the milk ducts of the breast.
- Other Likely diagnoses:
- Ductal ectasia: This condition involves the widening of a milk duct in the breast, which can cause a bloody or sticky discharge. It's more common in women who are nearing menopause but can occur at any age.
- Breast abscess or infection: Although less common, an infection or abscess in the breast tissue can cause bloody discharge, especially if it involves the ducts.
- Fibrocystic changes: While these changes are more commonly associated with non-bloody nipple discharge, in some cases, they can cause bloody discharge, especially if there's an associated intraductal papilloma or ductal ectasia.
- Do Not Miss diagnoses:
- Breast cancer: Although less likely, breast cancer, particularly ductal carcinoma in situ (DCIS) or invasive ductal carcinoma, can present with bloody nipple discharge. It's crucial to rule out cancer due to its significant implications.
- Pituitary prolactinoma: A prolactinoma can cause an increase in prolactin levels, leading to galactorrhea (spontaneous milk production), which can sometimes be bloody. This condition is particularly important to consider in women with other symptoms like amenorrhea or headaches.
- Rare diagnoses:
- Breast tuberculosis: This is a rare condition in many parts of the world but can cause bloody nipple discharge among other symptoms like breast masses or abscesses.
- Endometriosis of the breast: Although extremely rare, endometriosis can occur in the breast and potentially cause cyclical bloody nipple discharge.
- Neurofibromatosis type 1 (NF1) associated breast lesions: In patients with NF1, certain breast lesions can cause bloody discharge, though this is quite rare.