Under 50 years old
- Bloodstained or clear discharge
- Discharge of any nature from a single duct
- Discharge sufficient to stain clothes
Over 50 years old
- Any discharge
Do not usually require treatment or referral:
- Patients with a small volume of coloured or milky discharge from multiple ducts in females under age 50 years with no other breast symptoms – see Galactorrhoea advice below.
All patients referred with breast symptoms are seen within 2 weeks.
Characterised by a large amount of milky discharge from multiple ducts
History/examination to consider cause: physiological, drugs, thyroid disorder, pituitary tumour (visual field defects/ new headaches) / prolactinoma (menstrual disturbance/acne)
Check serum prolactin/TSH
- For serum prolactin the upper end of normal range is 496 mU/L in women and 324mU/L in men
- Raised prolactin levels are common (e.g. due to higher dose COCP or stress).
- In prolactinoma a very high value (over 1000 and usually several 1000mU/L) is expected.
If a patient has a very high serum prolactin and is not pregnant or breast feeding consider referral to Endocrinology not to breast surgery
For further information and interpretation of tests see patient.co.uk. The duty biochemist at RCHT can be contacted via switchboard for advice.
Date Reviewed November 2021
Next Review Date November 2022
Author Dr I Boyd, RMS GP Sifter
Reviewed By Dr M Attridge, RMS GP Sifter
Contributor Dr Rebecca Osborne, GPwSI Breast, RCHT
Version No. 3.0