Areola discharge

[RoseRedTattoo]

My 13yr old daughter has had a brownish coloured discharge leaking from her left areola (not from the nipple itself) for the last 3 weeks. There is no obvious mark or wound that the discharge is coming from. There is no lump, and it is not painful.

She has had a swab taken, blood test (for prolactin level) and an ultrasound, but doctors still don't know what it is. We have been referred to a breast specialist ... but I'm not sure how long before we get to see the specialist.

Does anybody have any ideas/been in similar situation? Surely 13 is too young for cancer? My mother was diagnosed with breast cancer a year ago, so I'm a bit worried

[RoseRedTattoo]

So I guess I've got everybody stumped with this one?

[csoar2004]

Originally Posted by RoseRedTattoo

So I guess I've got everybody stumped with this one?

Well, you have me stumped (not that difficult to do, lol). I'm wondering if your daughter recently started menstruating, because this type of thing is usually associated with hormones (hence the prolactin test). By doing a google search, I found the following info:

Only 10% of cases of nipple discharge are due to papilloma or cancer. Problems or disorders of the nipple are common and can be worrying, but changes are rarely due to cancer. If discharge is new and appears on one side only this needs a clinical examination and a mammogram. The most common cause is duct ectasia, but cancer needs to be excluded.

...A profuse, spontaneous, watery or bloodstained discharge from nipple or surrounding areola: This needs investigation, usually with microscopic examination (cytology) of the discharge and a mammogram. This may indicate a benign duct papilloma (a growth similar to a wart) or occasionally cancer. The majority of women with nipple discharge do not have breast cancer.

Mammary duct ectasia is a benign lesion of the breast that consists of dilation of the mammary ducts, periductal fibrosis, and inflammation. This entity has been described in infants, prepubertal boys and girls, as well as adult men and women. The patient presents with nipple discharge, which may be bloody in nature. In children and adolescents, the lesion is usually unilateral. Infectious and inflammatory causes have been implicated in the etiology of this finding. Ultrasonographic findings are usually suggestive, showing dilated mammary ducts radially located around the nipple. The process is usually self-limited; therefore, surgery is not recommended if the diagnosis is certain (Kitahara, 2002).

Here's a link that may help: [url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=A bstract&list_uids=21275791[/url]

If I were you, given your familial history of breast cancer, I'd get on the phone to doctor and find out a) when the appointment with specialist is and b) what ultrasound results show (for instance, though no lumps may have been found, were the mammary ducts dilated near the nipple as in ductal ectasia?) and c) what were the results of the swab test, and d) should the consult be with a breast surgeon/oncologist (because of history of breast cancer in direct female line)?

Mammary duct ectasia, from my google findings, is grossly underdiagnosed. While I'm not saying that's what your daugher has, if she were my daughter, I'd be morphed into guard/advocate momma-from-doctor's-worst-nightmare and demanding answers.

But that's me. Hope this helps.

best wishes,

charli
203/146/146 on the Fat Flush Plan for life and perky. Veddy, veddy perky

[RoseRedTattoo]

Thanks Charli, it was good to get a reply.

I have already started the guard/advocate momma-from-doctor's-worst-nightmare thing. It might be absolutely nothing .... but when it comes to your kids, you don't want to rest until you're certain that everything is ok.

The discharge just started for no apparent reason. My daughter has been getting her period for a bit over a year. The doctor had originally thought it might be hormonal ... but was then thrown out when it wasn't from the nipple itself. Prolactin levels were fine. Swab of the discharge came back clear. Ultrasound did show some cysts. The discharge is from left nipple only, and can leak spontaneously (without squeezing it or anything).

I will definitely look into the mammary duct ectasia thing. Thanks so much for your thoughts.

[RoseRedTattoo]

Have just found out it's going to be 2 months before we can see the specialist
Unbelievable!! The health system is the one place where you shouldn't have to wait so long