Bloody discharge

Hello Doctors,  

I'm 51 yrs old and I've been experiencing some spontaneous clear leakage for the past six months.  Which I assumed was hormone related due to my age.   I've been prone to cysts and even had one drained about 20 years ago now.  I had a mammogram and ultrasound done just over a year ago which showed a few small cysts but I wasn't having the discharge at that time. At Christmas time I did have extreme itching and tingling but that only lasted a few days.  I recenctly changed physicians and had an appt. for 'meet and greet' session.  I told her about the drainage at that time and also told her that I was due for a mammogram.  She advised me that she only does mammograms every 2 yrs on nonproblematic patients.   So I went home and the very next week the pain and bloody discharge began in  my left breast and nipple.   I called the office first thing Monday morning and they couldn't get me in for 3 weeks, but the nurse practioner was able to see me later that week.   The symptoms had subsided by then but she was still able to extract (with extreme pain) some bloody fluid for a culture and she placed me on Augmentin.  The office called 4 days later and told me that the culture was negative for bacteria but that they wanted me to stay on the Augmentin and scheduled a mammogram and ultrasound.   I've heard that even these tests can come back negative.  My symptoms are almost gone now.  Should I just wait until it happens again?  Why didn't they test for cancer cells (Paget's) when they had fluid for a culture?   Should I still be concerned when the symptoms are going away?   If the tests on Tuesday are negative should I pursue the issue?    Thank you for your time and expertise Holly

[Cleveland Clinic]

Dear Holly:  A general comment about nipple discharge.  Many women have some type of nipple discharge or fluid when their breasts are squeezed, and its normal. Squeezing the nipple sends message to the brain and the pituitary gland responds by increasing prolactin levels, which in turn produces discharge from the nipple. The discharge can come in a variety of colors - gray, green and brown as well as white. Some women are more prone to more discharge including women on; birth control pills, certain blood pressure medications or on major tranquilizers. These medications increase prolactin levels in the body. There is also certain life periods when a person is more likely to get discharge than others: there may be more discharge at puberty and at menopause than the years in-between. The time to worry about nipple discharge is when it's spontaneous (comes out by itself without squeezing), keeps on happening,is only on one side, and/or if it is clear and sticky, like an egg white, or bloody. If these symptoms are present a doctor should check you.

Regarding your situation, without evaluation, it is impossible for us to speculate on what might be the cause of your discharge.  There are certainly a variety of possibilities.  You may consider an appointment with a medical breast specialist who can help to evaluate the situation.  These are generally affiliated with large academic medical centers.  

In the US, the recommendation for screening mammography is yearly, regardless of whether there are problems.

[1234holly]

Thank you for all the information.  I'll follow through with your suggestions and will probably go to the Mayo Clinic for further investigation even if the symptoms have subsided.  Thanks again for your time.  Holly