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Bloody discharge from nipple

I am a 33 year old female. I got my nipples pierced about ten years ago and never experienced any out of the ordinary issues past the initial healing process. I would occasionally get the thick white discharge that accompanies nearly all types of piercings, but never any pain or swelling. Recently (about two weeks ago) I had some swelling in my left breast, just above the nipple. It was so uncomfortable I took the piercings out. Since then, the area above the nipple has become red, extremely tender, and the area feels very hard. The affected area is almost an inch across. My areola has also changed shape. the top looks stretched out, while the nipple itself sort of droops and looks inverted. Pushing on the area causes a discharge to come out of both piercing sites. It started out yellow/green, thinner than the discharge I was used to when the rings were in, but opaque. This evening the discharge was mostly blood, albeit thin, watered down blood. I try not to squeeze or put pressure on the area, as I am certain that if there is an infection, I am only making it worse, but I am monitoring the area that feels hard to see if it is growing and this makes the discharge leak out. My breast hurts constantly. I cannot wear an underwire bra for the pain it causes and have gone to wearing sports bras, or nothing at all (I am very small busted).
My question is : is this related to my nipple piercings? Could it be an infection? As I said before I have never had any issues with them. I had them the entire time I was in the military, wore a 40 pound flak vest with ballistic plates in it, and lived in more than one less than satisfactory environment. Only, now, after being out of the military for four months I encounter problems (go figure).
I am not pregnant, nor am I near my cycle, as I no longer have one due to a uterine ablation in 2009. I have had two lumps in my right breast biopsied and found to be benign. I AM going to see my GP about this, however I have to go through the VA and getting appointments can take up to or over three months. I do not generally search the Internet for medical advice, mostly because sites seem to do everything in their power to frighten you with outlandish diagnosis's.
My last question : would a cold or warm compress be beneficial? I fear, if it is an infection, that the heat may inflame it. I am just looking for some relief. I am unable to take most anti-inflammatory medications as it interferes with my arthritis medication, something I am reluctant to quick taking.
Any help would be appreciated, as I know I am not going to get to see a doctor anytime soon. Thank you in advance.
Best Answer
25201 tn?1255580836
You need to make an appointment with a Breast Specialist IMMEDIATELY !!! Get a referral from your regular Physician ... whether he/she be a Family Physician or your OB/GYN but do it NOW without delay.
With the other symptoms you mention this could be a very serious matter that needs to be investigated ASAP. I'm not even mentioning the piercings ... the symptoms are the important issue here. Regards ....
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Avatar universal
Thank you very much. I will indeed try to contact her. I greatly appreciate you indulging my questions.
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25201 tn?1255580836
Squamous cells are most often thought of as being associated with the skin but they can be present in other parts of the body. Since these cells in your case have been identified as "atypical" they are suspicious indeed. I suggest that you do get in touch with your Dr. even though you have the appointment next week. She could be waiting for further results though before jumping to any conclusions. Inflammatory changes would be present since the abscess was present. You might ask some questions regarding the Cytology report when you return to the Surgical Center. I would also still explore the issue of seeing a Breast Specialist and the Surgical Center might be of some help in this matter. Regards ....
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Avatar universal
Oh, in addition, the mammogram and ultrasound showed inflammatory changes. I'm not sure if that is relevant.
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Avatar universal
Well, after going to my follow up appointment I was admitted to the hospital for an incision and drainage of the abscess that had formed. I was released today with a lovely open wound and a 'wick.' While in the hospital I was given two courses of antibiotics via IV. My breast feels much better, but looks pretty nasty of course. I am due to go back into the surgical center in 48 hours for a check up.

When I was with my primary doctor, I overheard her dictating her notes to the hospital and she said that the second sample of discharge sent for cytology came back with atypical squamous cells. It was only today, that I thought about it, but when I tried to call her office I could not get through (constant busy signal). I emailed her asking to call me, and am still waiting. I know she wants to see me next week for a follow up, but I am wondering what the cytology means. Any help or advise is greatly appreciated.
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25201 tn?1255580836
I'm not sure you need a referral to see a Breast Specialist .... you might call the Hospital and ask which Dr.s are available with this type of practice as their specialty. I'd go ahead and make an appointment myself if at all possible. You've waited quite long enough even though Mastitis is a stubborn condition to treat. Give it a try .... Thanks for the update.
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Avatar universal
It was indeed just a prescription change. Picked up the antibiotics eight days ago and they haven't done squat to the infection. It's just as bad as it was before the first course of antibiotics. Had mammo and ultrasound yesterday and the attending dr there says The US shows i have 'lots of cysts' but no abscess (thank goodness). Mammogram wasn't evaluated yet. Waiting on dr to call me or I'll just have to wait till my appointment on the 1st. Still haven't heard back on cytology. Which in my mind, no news is good news.
My breast is looking awful. There is a crescent shaped red/purple area around my nipple that's about an inch out, still from 9 o'clock to 3 o'clock. It's still swollen and and painful. And now I have a larger ring all the way around the breast that's lighter in color. Basically covers my whole breast. I had massive discharge last night which I assumed was from the mammo.
I am hoping the dr refers me to a breast specialist after our next appointment. This is getting really irritating. I just want this cleared up!
Helpful - 0
25201 tn?1255580836
Possibly something came up that changed whatever she had ordered .... by the way ... antibiotics / diarrhea, eat yogurt; it will help with that problem. I always have to rely on yogurt with ANY antibiotic.
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Avatar universal
Well, the doctors appointment went much as I thought it would. She prescribed another round of antibiotics. Evidently stronger ones that may or may not give me diarrhea and a yeast infection (yippee). The cytology results weren't back yet, so more waiting. She tried calling the lab, but they were out to lunch. She says there is not an abscess, but that it looks pretty awful. She also said to just stick to warm compresses. In addition to the antibiotics she prescribed some oxycodone for the pain, particularly for the day of and the day after the mammo.
After I returned home this evening I saw that I had a voice mail from her office. When I checked the message she simply told me I needed to call her back in the morning before I picked up my meds.  So I'm not sure if she changed the meds or the lab called her back. Guess I will find out tomorrow.
Helpful - 0
25201 tn?1255580836
That's OK ... Rant away :) Mastitis is always a tough one. I would think another round of antibiotics might well be in order, perhaps a different one. Hopefully the Ultrasound and Mammogram will offer some more answers. I'm not sure I'd be trying too many home remedies though; unless you are checking them out with the Dr. first. Some things may be OK even though they don't do any good but some might also do some harm or at least complicate matters. Hang in there ....
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Avatar universal
Well, unfortunately I think this is going to be a tough case of mastitis to clear up. The symptoms have returned in full force. The redness around the areola has intensified. The pain is quite distracting. My breast is also swollen to twice its size. I'm not sure if there is an abscess in there or not. My nipple, which is usually quite big, is flattened and even with my areola. There is no longer any discharge, but my breast feels...full.
The retest that the dr did two weeks ago came back with no Staph so the antibiotics cleared it up. The cytology results are not back yet so I'm unsure if there are abnormal cells. I see the dr again tomorrow, so hopefully she will let me know if there was anything abnormal.
I'm curious if the next step will be another round of antibiotics. I am scheduled for an ultrasound and bilateral mammogram on 23 July. I am currently going to grad school and the appointments are starting to interfere with my schedule at school, which is bothersome. I am reluctant to undergo any type of surgery at this point. i have tried every home remedy and had no relief. Even walked around with cabbage leaves in my bra :) which did nothing but create a strange smell and sensation.
Hopefully tomorrow brings some answers. Thank you in advance for reading my pointless rant.
Helpful - 0
25201 tn?1255580836
Thanks for the update ... I'm glad that you are going to have some further testing and "Hooray" for your Doc for covering all the bases. Patience is difficult but necessary. I'll keep my fingers crossed for you too so keep the updates coming ..... Take care
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Avatar universal
An update :
So after taking the antibiotics, the pain, swelling and redness did indeed go away. There is still a spot around the areola (from three o'clock to nine o'clock, starting at/under the areola, going about an inch out) that is still swollen and bruised looking. The skin in that area is also peeling and dry looking. I am still having a dicharge from the nipple, but it is not the thick yellow or the blood tinged. It's  coming out clear and watery. The doctor called me last week when she got the pathology results back and said it was positive for Staph, but that she would still like to see me on the 27th. When I went in yesterday she said the cystology came back with abnormal cells. She made it clear that the abnormalities could be a result of the test itself. She took another sample to redo the test. She was also able to feel a lump adjacent to the areola, measuring 2 cm wide, 1 cm long. She went ahead and ordered a bilateral mammogram and ultrasound, to be done on 25 July. She also wants to see me again in July to see if the swelling of the nipple has gone down.
The lump she felt is quite painless. The skin feels kind of thick. The pain I was feeling when the infection was at its worst is gone. Now I only have sharp, shooting pains that come and go every few hours.
I will continue to posts updates as they come. I know I just have to be patient and wait for the test results. Fingers crossed that it was just a bad sample the first time!
Helpful - 0
25201 tn?1255580836
You should be aware that often mastitis is quite difficult to treat but if it is indeed mastitis I hope it will be one of the more simpler cases and easily resolved. Be sure you do follow-up in the recommended 2 weeks for the Mammogram / Ultrasound if it isn't resolved by then. Thanks for the update; we appreciate knowing how things turn out. Take care ...
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Avatar universal
Went to the doctor today after having my initial appointment rescheduled by the doctors office. The GYN I saw thinks it is mastitis and prescribed a ten day course of antibiotics. She also sent a slide of the discharge off to the lab. I have a follow up in two weeks. Se said if I wasn't responding to antibiotics they would then order an ultrasound and mammogram.
I did ask about the warm and cold compress's when I scheduled. The doctor said to continue with that everyday as well as the antibiotics.
Having never had children, I have never experienced mastitis so I had no idea what the symptoms were. Luckily I haven't had any fevers, aches, fatigue or flu-like symptoms. At its worst my breast looked pretty awful. It swelled up to almost twice it's normal size. I had redness all the way around my nipple and two inches out (which is most of my boob).
I'm glad I was given such good advice here that prompted me to see the doctor. I would hate to see how uncomfortable this could get. Many thanks!
Helpful - 0
25201 tn?1255580836
Did you ask her about using the hot/cold packs ?? If not you should before you continue using them. This might just be a simple infectuous process but those symptoms are also an indication of something more serious .... good going in following the advice; we appreciate that here, some women choose to just WAIT and SEE. Please let us know what you find out after your visit to the Dr.    Regards .....
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Avatar universal
Thank you so much for the advice! I emailed my doctor and she is able to get me in 10 June. In the meantime I am alternating between hot and cold packs to relieve some of the pain. I am not the type of person who panics easily, but I admit the blood was somewhat alarming.
Helpful - 0
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