Going insane!

[Jaydra]

I am 31 years old and I've had some testing because of lumpy breasts and a feeling behind my nipple like there is a tube attached to it (enlarged duct?)... I had a fine needle aspiration which came back fibrocystic changes
then I had a mammogram and ultrasound that showed nothing

then I start having some discharge (white to green in colour.. sometimes pasty where it isn't very liquidy)

I get sent to a surgeon who is convinced it's nothing but fibrocystic changes with duct ectasia but I get him to do another biopsy anyways.

that one came back atypical indeterminate cellular, possible papillary no malignancy detected. (whatever all that means) and I see him again next week.

today my nipple felt weird.. I gave it a little squeeze and out came the usually greenish looking discharge. Gave it another little squeeze and out popped some blood.

any idea what on earth is going on??

[Jaydra]

I saw my surgeon today and he figures the blood that came out was from the biopsy (as you suggested)

He figures and to quote him he's "fairly certain" that I have a papilloma and I will be having a duct excision in 2 weeks.

I know these are usually benign, what are the chances that a papilloma or papillary lesion in general could be malignant? Is it unusual for a papilloma not to show up on imaging?

[Cleveland Clinic]

Dear jaydra:  Duct ectasia is a widening and hardening of the duct.  It usually affects women in their forties and fifties and can be characterized by thick green, black or clear nipple discharge.  The nipple and surrounding tissue may be red and tender.  Occassionally a hard lump can develop around the abnormal duct.

Duct ectasia is usually diagnosed through physical examination and ultrasound, although additional testing may be recommended such as mammography, depending on the age of the woman. Ultrasound is very good at differentiating a solid vs. cystic lump but is not
specifically diagnostic.  The data from ultrasound must be considered as part of a total picture. Duct ectasia may or may not need treatment.  It may improve with heat application or antibiotics.  In some cases, the affected duct(s) can be surgically removed.

Women can 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 be concerned about nipple discharge is when it’s spontaneous (comes out by itself without squeezing), keeps on happening, and is only on one side.  If it is clear and sticky, like an egg white, or bloody.  Bloody discharge could be a symptom of something more serious.   In your case, it may be due to the biopsy.  However, you may simply want to discuss this with your doctor who who knows your situation and discuss in the context of you.