I am 48 years old, and have had persistent non-spontaneous milky discharge from both nipples, multiple ducts, for years. Substantial amounts when I squeeze even a little bit (which I didn't do very often--I checked every couple of months or so). Then about a month ago I notices a dark bloody discharge coming out of one duct, left breast (still non-spontaneous, except very occasional very tiny spotting). When squeezed lightly, significant amount of dark bloody discharge comes out of same duct. Went immediately for consult with breast consult surgeon, who sent me for a mammogram and ultrasound. Mammogram showed asymmetric density in left upper outer quadrant. Nothing that correlates with the discharge. Ultrasound showed multiple dilated ducts in left nipple, but no indication of why. Both tests designated as inconclusive. I was told to do a BSGI because of dense, lumpy breast tissue that is making it hard to assess. A couple of other maybe related things--had some hormone work done about three months ago--showed low-normal prolactin levels, high (650-ish) estrodial levels, and very low progesterone levels. So, is bloody discharge that is indicative of a malignancy ALWAYS spontaneous? Why so much discharge with low prolactin levels? Is the bloody discharge related in any way to the milky discharge? Should I push for a biopsy even if this next test comes back negative? I'm getting really worried. Thank you!
First of all, bloody discharge does NOT always mean a malignancy .... discharge isn't of much concern normally unless it is bloody and from one breast only and completely spontaneous. I'm not sure what you would have biopsied ..... there could be a washing out of the ducts and the fluid tested as this could be due to a benign ductal issue. I would suggest that you NOT continue squeezing though .. this sends a signal to the brain to produce discharge. My best advice would be to concult a Breast Specialist and have him/her go over all your films and investigate the ducts (ductogram) and go from there. By Breast Specialist I don't necessarily mean a Surgeon which you've already seen. There are several ways to treat a ductal issue and there's always a chance that a Papilloma may be involved but I would think that would have been evident on film. The ducts can also be completely removed surgically so keep looking until you get a satisfactory answer. Regards ....
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