🌿 Folk Prescriptions

In general, bilateral nipple discharge is often physiological or systemic in nature—for example, newborns may secrete small amounts of milk during the first 1–2 weeks after birth due to high estrogen levels inherited from the mother. Adults may experience galactorrhea-amenorrhea syndrome due to hypothalamic-pituitary disorders. Unilateral nipple discharge is typically pathological and mostly due to local lesions such as benign breast duct disease or breast cancer. Multiple-duct discharge may be physiological or indicate extensive pathology, such as mammary duct ectasia syndrome or breast hyperplasia. Single-duct discharge is often due to lesions in a specific duct, such as intraductal papilloma or intraductal papillary carcinoma. If discharge occurs spontaneously, it usually indicates significant fluid accumulation within the duct and ongoing secretion, suggesting a higher likelihood of pathological discharge. If discharge occurs only upon squeezing, it suggests less accumulated fluid, and the site of squeezing may point to the location of the lesion.
Careful observation and identification of the characteristics of nipple discharge are crucial for determining its cause. Generally, milky discharge appears as spontaneous, bilateral, multiple-duct discharge outside lactation, resembling skimmed milk in appearance and consistency, commonly caused by hypothalamic dysfunction and abnormally elevated serum prolactin levels. Serous discharge is usually squeezed out, though occasionally spontaneous, often wetting clothing. It may occur unilaterally or bilaterally, appearing thin, transparent, pale yellow, brownish, or sticky. It is commonly caused by benign breast diseases such as breast hyperplasia, mammary duct ectasia syndrome, or intraductal papilloma. Rarely, serous discharge may result from breast cancer. Watery discharge is usually unilateral, clear and colorless like water, often caused by tumors. Some scholars suggest that about 50% of watery discharges may be malignant. Purulent discharge is usually unilateral, occurring spontaneously or upon squeezing, appearing green or yellowish-white, thick and pus-like, sometimes mixed with blood. It is commonly seen in inflammatory breast diseases such as mammary duct ectasia syndrome. Bloody discharge is usually unilateral, occurring spontaneously or upon squeezing, appearing bright red, pale red, light brown, or coffee-colored. It is most commonly caused by intraductal papilloma, but may also occur in breast cancer, breast hyperplasia, or mammary duct ectasia syndrome. Since malignant lesions more frequently cause bloody discharge, clinicians should be particularly vigilant regarding the possibility of malignancy in patients with bloody nipple discharge.
Additionally, it is important to distinguish true nipple discharge from false discharge. True discharge originates from breast ducts through the nipple opening, whereas false discharge typically results from superficial erosion of the nipple or secondary infection due to breast duct fistula, causing inflammatory exudate. The term "nipple discharge" here generally refers to true discharge.
In summary, any occurrence of nipple discharge—regardless of mode or character—should be taken seriously, as non-lactational nipple discharge is almost always a sign of various breast diseases. Particularly noteworthy is that male patients with nipple discharge have a higher likelihood of breast malignancy and must not be overlooked.
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