unilateral nipple discharge

[ashsky]

In January of this year, I noticed a strange lump in my left breast while changing clothes.  It wasn't palpable during an exam, but it was visible when looking in the mirror. The dx mammo and u/s revealed nothing of concern and I was told if I had nipple discharge or pain, then to come back.

5 months later, I notice pain in that same spot.  I was about to start my period, so attributed it to that.  Then in the bath that night, I looked down and saw a drop of a clear, yellowish, sticky substance on my left nipple.  I realized it was only coming from one breast, and only from one pore on that breast.  The discharge has persisted for a month and seems unrelated to my cycle.  It is a small amount, never more than a drop or two.  It discharges spontaneously about 2x a week and I can almost always trigger it when I sqeeze.  Unless I'm at the dr's office trying to find out what's going on with me.  Then nothing came out.

The nurse practitioner would like me to see a neurologist to rule out something with my pituitary and drew blood to check my prolactin levels.  And, okay, I'm not a doctor, but I do make an effort to educate myself and it seems that they would want to rule out anything in my breast before looking elsewhere in my body for the cause.  It is always the same duct on the same breast that had the lump.  The pain is exactly where my lump is, so it seems logical that there is a physicologic cause, rather than a hormonal one.  

I suppose my question is: should I seek a second opinion immediately, or should I pursue the prolactin pituitary thing first?  Or should I pursue both avenues simultaneously?  Or neither?  Thanks in advance for your opinions and thoughts.

Oh, and I'm a 29 year old mother of 2 (ages 4 & 5) (and they've been weaned for 3 years) who is otherwise in great health, if that makes a difference....

[LToot]

I'm going through the exact same thing as asksky. Spontaneous yellow discharge for several months on right breast only.  My ob/gyn and surgeon told me not to worry about it, but after reading this, I'm going to find a breast specialist and get a second opinion.  It just doesn't seem right.

A patholoy report from a recent needle biopsy revealed atypical ductal hyperplasia on the right breast as well at 8 o'clock position.  I'm scheduled for a surgical biopsy in 1 month.

Do you know a good breast specialist in Washington DC

All this happened about 9 months post menopause.

[Cleveland Clinic]

Dear ashsky:  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.

Without ability to ask questions and perform physical examination it is difficult to evaluate the situation fully.  However, since prolactin is commonly associated with nipple discharge, it makes sense to draw prolactin levels to rule that out and this could be done simultaneously to pursuing other avenues.  If you are still uncomfortable with your doctor’s or nurse practitioner’s recommendations an evaluation by a breast specialist (these are usually affiliated with large academic centers) is another option for you.