The term “nipple discharge” refers to any fluid that leaks out of the nipple(s) of the breast. Nipple discharge is a normal part of breast function during pregnancy and breastfeeding, and can be a normal result of menstrual cycle hormone changes. Nipple discharge in a woman who is not pregnant or breastfeeding is not necessarily abnormal and can be caused by many factors but should be evaluated. Nipple discharge in a man is not normal under any circumstances and requires further evaluation.

Normal (Physiologic) Nipple Discharge

Nipple discharge is considered normal when it is nonspontaneous (that is, resulting from manipulation) from multiple breast ducts. The color of the discharge may be yellow, white, gray, green, blue, or even dark brown. Normal nipple discharge can occur due to pregnancy or breastfeeding, following breast stimulation with intercourse or a warm shower, and in women with thyroid conditions or hormonal imbalances or who are taking certain medications, including estrogens, oral contraceptives, opiates, some antihypertensive medications, antipsychotic medications, and some antidepressant medications.

Suspicious Nipple Discharge

Nipple discharge is considered suspicious when it is spontaneous (occurring without manipulation of the breast) and persistent, unilateral, coming from only one duct with fluid characterized as clear and colorless, bloody, or pale yellow and transparent. Causes of suspicious nipple discharge include:

• Papilloma—A small, usually noncancerous or benign lesion that grows in a milk duct of the breast
• Ductal ectasia—A widening and thickening of the walls of a milk duct that cause the duct to become blocked, leading to fluid build-up
• Cancer

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