Expert: Claes-Gustaf Nordquist, M.D. - 5/22/2008

Question
QUESTION: Hi. I have been trying to get myself in better health, by doing screenings, etc.. I always make my annual female apt, but I am a few months behind. In the meantime, I do self exams. Well, since having my son, two yrs ago, I have had really fibrous feeling breasts. At my annual, last yr, the OBGYN said everything seemed fine. I also used to get a yellow/green breast discharge from both breasts,which has been going on for about 10 yrs. I had an OBGYN do a lab test on these before son was born, and she said everything seemed normal. Well, I bf my son for 5 months- 2 yrs ago, and since then, I have hardly if any green/clearish discharge in one breast-only by manipulation, but the other one has a milk-like discharge, so it is basically confined to one breast, which is troublesome. I am hoping that I am not getting something terrible. I have had some weird things come up before, and the OBGYNs looked at these, like growth under arm, etc... and said these were not breast related, just normal follicles. Is it normal to have this kind of discharge? I also have so many lumps in my breast that I can't tell a good one from a bad one, as I am a bit overweight and the breasts are different from bf. Thanks.

ANSWER: Only blood discharges from the breasts are associated with breast cancer. If your breasts are that lumpy the best breast check ups are done with MRI breast scans. Any unclear lesions should be investigated with needle biopsies. Good luck!


---------- FOLLOW-UP ----------

QUESTION: Thanks for your response. Now my question is, My new obgyn looked at things and said everything looked ok, but she is referring me to a general surgeon to check my chest and see if they want to do a biopsy or ultrasound. My thought is could this not be done by her? Could she not squeeze a bit harder-as my last dr did and get the fluid out herself to put on a slide,etc... Why would a surgeon be the one to review this,when this office has mammogram equip on site? I am confused. I was kind of nervous about this and my family said I should, perhaps go back to my old doc or get another one to check this out. The new one is doing some blood work, but that is about it besides the referral. I think I put this in my last post, but I have also had a pea sized lump near my breast/arm pit for 7 years. I was with the same practice for 10 years and showed this to every doctor almost at every yearly-none of them thought it was anything. Even showed my dermatologist. One Nurse Prac looked at it and started to give antibiotics before even doing bloodwork, so I didn't really follow the orders-this was a new nurse practitioner and this issue was going on for a year at that point. Well, I have decided to switch my doctors again as this last OBGYN has annoyed me to some degree. I do know in her office, they offer mammograms, ultrasounds, etc... she is sending me to a surgeon to get a breast check there. I would've hoped she would be able to do this and get the testing in her office. I also have heard this woman doesn' listen to patients and is very pushy to some degree. I have an apt with a well established OBGYN/office this week and will try to show the discharge to the next dr, since she was unable to get any out on exam, which is easy for me to do. I am so terrified about whatever is going on. I am fairly young-33 do you think there are other things besides negatives with these symptoms. Also, what questions and things should I bring up to the new dr? I am certain I will be sent for tests, but the office sounds like it is pro getting ultrasounds, etc... I did do some lab work for the last dr, but will the results be sent back to me since I am leaving? I wouldn't typically leave this soon, but I have been feeling iffy about this doc for the past two yrs, and have had rec'd a ton of negative emails about this doc from a mom board, just want to be proactive. I also can not afford to be sent to every specialits when there are ample resources on site. Well, thanks.

Answer
I doubt very much that this discharge is dangerous in any way. If your breasts are very lumpy mammography should ALWAYS be complemented with BOTH ultrasound AND MRI scans. Any unclear things seen should be checked with needle biopsies (unfortunately not available everywhere). The only test of the discharge itself of any value would be exfoliative cytology.
Another x-ray examination would be galactography of your discharging milk ducts. That is the advice I can offer here.