Dear Reader,

You don't say if you are a man or woman, or how old you are. Many women can have some discharge from their nipples upon squeezing the breasts; men rarely have any discharge from their nipples, even with squeezing.

Usually the discharge seen after squeezing the breasts is milky. Thin, clear, or greenish discharge often occurs in women who:

• are experiencing hormone shifts just before the beginning of their menstrual period
• use birth control pills
• are pregnant
• have breastfed a baby within the previous several years
• have developed a breast infection (mastitis)
• have cysts within their breasts, fibrocystic breast changes (lumpy, thick areas within both breasts that are made up of both cysts and fibrous, scar-like tissue), or more complicated changes in the cells that line the tubular system (ducts) within the breast (a condition called ductal ectasia)

If there is a similar discharge in men, it is critical to get it checked out. Although benign causes are much more common than malignant ones in men and women, nipple discharge in men is more likely to have a higher rate of malignancy than nipple discharge in women.

Discharge that occurs without squeezing, also known as spontaneous discharge, tends to be of more concern. A variety of hormonal changes can cause this in either men or women. And bloody discharge, in particular, can suggest the presence of a growth. Such growths may be benign (such as a papilloma — a warty, noncancerous tumor that grows on a stalk) or malignant (such as a cancerous tumor) within the ducts of the breast.

Any time you are concerned about nipple discharge, it's important to make an appointment with your health care provider to have it checked out. The discharge fluid can be tested in a laboratory to reveal some information. Blood tests can make sure that you don't have any abnormal hormone levels that might account for the presence of nipple discharge.

Your health care provider can also do a complete breast examination to make sure there's nothing abnormal that can be felt within your breasts. Depending on the outcome of the laboratory work and the breast examination, your provider might recommend that you undergo a mammogram or an ultrasound examination of your breasts to check for cysts, fibrocystic changes, ductal ectasia, or tumors.

Here are some important tips for women to maintain breast health:

• Learn how to do monthly breast self-exams. Instructions can be found on the American Cancer Society's How to Perform a Breast Self-Exam web site, and a computer video on breast self-examination can be watched at The Susan G. Komen Breast Cancer Foundation web site.
• Get a yearly breast exam from your health care provider.
• Women over forty years need to have mammograms yearly; women with an increased risk of breast cancer due to family history need to consult their health care providers for advice on whether to begin receiving mammograms before age forty.

Best of luck,

Alice

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