can a nipple that bleeds not be cancer?

Two years ago I returned from a long hike to find a tiny spot of blood in my sports bra.  I saw my OB/Gyn who could not make the nipple bleed, but sent me to see a breast surgeon for safety's sake.  The surgeon performed a surgical biopsy with an incision half way around the areola and removal of milk ducts.  The pathology report came back negative.  However, in the time since the surgery, there have continued to be instances (such as vigorous use of a wash cloth) where the nipple bleeds from the side.  It also seems to have an opening.  My original surgeon said that this was just from "having a weird anatomy."  I sought a second opinion yesterday from a surgeon who now plans to do a surgical biopsy of the nipple to rule out Paget's Disease.  My question is:  Is it possible or likely for someone to have a bleeding nipple and NOT have Paget's Disease or another form of cancer?

[PaulMD]

Hi there.

Yes.  In fact, the most common cause of bleeding from the nipples is breast duct papilloma which is a benign lesion.  However, the treatment for this is somewhat tricky.  The surgery should be done during the time of active bleeding so that the papilloma can be localized.  I suggest you discuss this possibility with your surgeon.

Regards and God bless.

[Dixsonian]

To PaulMD,

Thank you for your kind response.  My breast surgeon plans to remove a pie-shaped piece of the nipple for the biopsy and suture what remains.  Do you think that this would indicate that he has a degree of certainty that this is, in fact, cancer?  Would the procedure that you described be possible after the site is sutured?

[PaulMD]

The surgical procedure for the papilloma may not be affected too much by this biopsy procedure.  I believe that your doctor has the diagnosis of cancer at the back of his mind, but just by the nature of the procedure, we can never really tell if this is cancer.  I sure hope that the biopsy findings will turn out OK.

[Dixsonian]

To PaulMD,

Thank you for responding to my questions.  I have to ask about your statement that "just by the nature of the procedure, we can never really tell if this is cancer."  Does this mean that the type of surgical biopsy my surgeon is planning on employing is not definitive for the presence of cancer in the nipple and/or the breast?  

Kindest Regards

[PaulMD]

The biopsy procedure will be definitive.  What I meant was, we cannot tell if the true nature of the lesion just by the nature of the biopsy.

[Dixsonian]

Today (July 18) I received the results from my breast biopsy that was performed on July 14 to check for Paget's Disease.  GREAT NEWS!  My problem of a bleeding nipple was not caused by cancer!!  What a relief!  The nurse was a little unclear about the actual name of my problem.  She said that there was a benign growth in a duct.  Is that the definition of duct papilloma?  The nurse said that the surgeon removed the growth during the biopsy, but she did not say anything about the duct being scoped.  Does this sound like the usual protocol?