Breast Nipple Discharge
Frederick R. Jelovsek MD
Dark green nipple discharge - mammary duct ectasia
I am 28 with fibrocystic breasts. For the past week my left breast has oozed dark green fluid but I do not have the usual swelling or pain. Could this be cancer? My doctor has ordered a mammogram.
The discharge may be due to the fibrocystic disease. However, such greenish discharge is also characteristic for an inflammation of the breast ducts called mammary duct ectasia which is not usually related to an underlying cancer nor does it put you at greater risk than the normal for breast cancer.
Ectasia is an inflammation of the breast ducts that is not caused by bacteria. While it is usually a benign process, it can sometimes look like a cancer on a mammogram and thus will most likely require a biopsy.
Also, surgery may be indicated if there is a very persistent, copious discharge, breast pain, nipple retraction or an underlying mass thought to be an abscess or inflammatory mastitis.
It is difficult to treat and excision of the inflamed ducts is only about 85% successful. Whether the mammogram is benign or not, you should see a surgeon experienced in breast disease for further management.
If it turns out to be mammary duct ectasia, you may want to read:
Periductal mastitis masquerading as carcinoma
Miller SD, McCollough ML, DeNapoli T,
Department of Dermatology, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200, USA.
Dermatol Surg 1998 Mar;24(3):383-5,
Periductal mastitis (mammary duct ectasia) is a little appreciated, often unrecognized entity that may present to the dermatologist. We present our experience with this disease and hope to familiarize the reader with a condition not well known to most dermatologists.
Periductal mastitis is a benign mammary duct disease that begins with periductal inflammation and progresses to ductal dilatation with minimal inflammation (ductal ectasia). The clinical and radiographic appearance of this disease can be indistinguishable from carcinoma of the breast.
[The duct ectasia syndrome--an overlooked disease entity]. [Article in Danish]
Petersen L, Graversen HP, Andersen JA, Dyreborg U, Blichert-Toft M, Odense Sygenhus, Kirurgisk afdeling K.
Ugeskr Laeger 1993 May 17;155(20):1540-5.