is breast bloody discharge caused by high prolactin, by infection or by papilloma

[samar1966]

I got blood discharge from my left breast , the mammogram and ultrasound showed mild ductal ectasia in the left retro-areolar area and a tiny benign looking opacity is seen in the lower part of the right breast . but MRI of breasts showed moderate bilateral glandular enhancement,that appears to be mildly linear in the right retroareolar region just below the equator that is most likely benign in appearance. While breast fluid cytology of both breasts showed macrophages representing the content of a cyst with possibly associated intraductal papilloma.I am taking respirdal 2.5 mg and Zoloft 50 mg .that cause high prolactin level ( before I got milk secreation. and pain and congested breasts). My question is : May this problem be caused by the increased level of prolactin or by infection ( I wore a new bra before washing it) or it may be papilloma  ????? Please answer me I am worried alot. Thank you in advance.

[zouzi]

Hi again,
Like bluebutterfly 2222 I am so glad to know that no suspicious cells were found! That's good news we always like to hear! :)
Because you are taking an antidepressant drug which elevates the prolactin level in your body,I would like to suggest to you,to avoid squeezing your nipple to check for discharge.Leave it alone and the discharge will hopefully stop.
Always be vigilant during these 6 months waiting for your next follow up.Do your SBE (self breast exam) monthly,a week after the start of your period to check for any lump that may develop.If you notice any changes in your breast,don't hesitate to call your doctor for a check up.
All the best ....

[bluebutterfly2222]

Thanks for giving us an update!

I am very pleased to hear that the repeat fluid cytology did not show suspicious cells, and that you will only need  followup imaging.

Best wishes...

[samar1966]

Thank you for your answer . What I did is that I repeated the fluid cytology in another pathology lab which is more famous and the result was cyst mastopathy with no suspecious cells so my physician adviced me to do ultrasound of breasts after 6 months then mammography and u/s after one year as follow up.

[zouzi]

Hi,
All the things you mention,breast infection,fibrocystic breasts,introductal papilloma,mammary duct ecstasia, and unfortunately in a minority of cases also cancer,could cause a bloody discharge from the nipple.
ISince you had a breast fluid cytology done,I would lean more on what the results state that it's more likely an intraductal papilloma,which is a noncancerous tumor that forms within the milk ducts of the breasts.
Intraductal papilloma occurs most often in women ages 35 - 55. The causes and risk factors are unknown.
Almost all these type of tumors are treated by removal, along with part of the duct in which it was found.The tissue is then examined to be sure it is not cancerous.
The odds are way in favor of being a benign process but even with the small chance of malignancy, if treated early it is entirely curable.
Sending you my best wishes...

[bluebutterfly2222]

The elevated prolactin level would not cause a bloody discharge from the breast.

The breast fluid cytology report would  give an indication of whether or not an infection was present. A papilloma can cause a bloody discharge.

The doctor who  ordered the various imaging and other tests would  be the best person to explain all of the test results to you, and to make recommendations in regard to what should happen next.

Please update us on how things turn out, by adding additional posts to this same thread.

Best wishes...