A milky discharge from multiple ducts in the nonlactating woman suggests which condition?

A milky discharge from multiple ducts in the nonlactating woman suggests which condition?

• A. Hyperprolactinemia
• B. Fat necrosis
• C. Intraductal papilloma
• D. Purulent discharge

Answer: (A)

Milky discharge from multiple ducts in a nonlactating woman points to galactorrhea caused by elevated prolactin (hyperprolactinemia). Prolactin stimulates milk production, and when levels are high outside of pregnancy or lactation, the breast can secrete a milky fluid from several ducts. Common causes include a pituitary prolactinoma, medications that reduce dopamine (such as certain antipsychotics or antiemetics), hypothyroidism, and renal failure. This type of discharge is typically bilateral and may be accompanied by menstrual disturbances or infertility because high prolactin suppresses GnRH. In contrast, intraductal papilloma usually presents with a unilateral, serous or blood-tinged discharge from a single duct, and purulent discharge suggests infection; fat necrosis is not a typical cause of milky discharge.

Milky discharge from multiple ducts in a nonlactating woman points to galactorrhea caused by elevated prolactin (hyperprolactinemia). Prolactin stimulates milk production, and when levels are high outside of pregnancy or lactation, the breast can secrete a milky fluid from several ducts. Common causes include a pituitary prolactinoma, medications that reduce dopamine (such as certain antipsychotics or antiemetics), hypothyroidism, and renal failure. This type of discharge is typically bilateral and may be accompanied by menstrual disturbances or infertility because high prolactin suppresses GnRH. In contrast, intraductal papilloma usually presents with a unilateral, serous or blood-tinged discharge from a single duct, and purulent discharge suggests infection; fat necrosis is not a typical cause of milky discharge.