Dedicated to the care of breast cancer and all breast conditions
Dr Sarah Rayne is no longer practising in
Johannesburg and this practice is closed.

These pages are for information only,
and current only until 2018
I’ve just been diagnosed with breast cancer- help!
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I’ve noticed a lump in my breast
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I have breast pain               
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I need advice about breastfeeding
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Nipple Discharge  
Noticing a discharge from your nipple can be worrying. Most of the time, a good consultation and examination can determine what the cause could be, and investigations such as a mammogram, ultrasound or blood tests will help confirm.
Questions to ask yourself
There are three questions you should ask yourself about your discharge:
Are you squeezing?
Does the discharge come only when you squeeze or do you notice it on your clothes or the inside of your bra?

Squeezing your breast or nipple can often result in normal discharges or fluid being expressed. It can also stimulate the breast to produce fluid. It is a good idea to avoid squeezing your nipples yourself.
Is the discharge from one duct, one breast or both breasts?
This helps determine what is causing the discharge. Discharges from both breasts tend to have a hormonal cause more than discharges from one duct- which are more likely to have a problem going on in that duct alone.
What is the colour?
Infections and inflammation can cause a yellow, green or white discharge and other causes lead to a clear or milky discharge. Blood in a discharge is an important sign.
What can cause a discharge?
Physiological discharges
These discharges occur in both breast and tend to be due to a hormonal problem. They can also occur if the nipple is excessively stimulated such as in with the friction of clothes on the chest wall in runners or by squeezing the nipples. The discharge is most commonly milky. The hormonal problems may be due to the thyroid, the pituitary gland producing too much prolactin, or medications such as anti-depressants or other medicines causing a block in hormone levels.
These are non-cancerous growths of the cells that line the breast ducts. 10-20% of these growths can hide small areas of early cancer therefore it is recommended that they are surgically removed with a small operation.
Duct ectasia
The breast dicts closest to the nipple can become enlarged as they lose their elasticity. The duct then fills with debris and can become inflected or inflamed. There is no increased risk of cancer with this problem, but infections, pain and itching. The symptoms can be treated with simple measures but in a few complicated cases, some surgery to remove the ducts is required.