cysts and brown (bloody?) discharge

i went to the doctor a few weeks ago because of a brownish nipple discharge from one duct in my right breast, which occurrs only with manipulation.  i could feel no masses.  the dr did a nipple smear and tested my thyroid.  i had a mammogram and an ultrasound.  today i went back to the dr. to go over the results: mammogram was normal, ultrasound showed a few cysts and "prominent ducts" beneath the areola and requires a 6 month follow-up, and the nipple smear found no malignant cells but cystic fluid.  i am 30 years old, and have a strong family history of breast cancer, so i want to be very careful.  the dr. knows this, and referred me to a breast surgeon, but i couldn't get an appointment until the end of next month.  the dr. said it might be a papilloma, but none showed up on the imaging.  while i wait for the specialist, does anyone have any ideas what might be behind these symptoms? thanks!

[Cleveland Clinic]

Dear carolee407,  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, and is only on one side.  If it is clear and sticky, like an egg white, or bloody.



An intraductal papilloma is a benign finding and does not increase the risk of developing breast cancer. They usually develop naturally as the breast ages and changes.

For women who develop intraductal papillomas, those reaching menopause are more likely to have a single papilloma, while younger women may have more than one.  The breast surgeon who will be able to review the testing and with physical examination be better able to make recommendations for any further evaluations if necessary, as well as how best to follow-up.