Library
Breast
·
easy
Nipple Discharge
Flowchart
Play
Bloody/serous = pathologic. Milky = endocrine workup.
Decision
Outcome
Decision
Unilateral breast nipple discharge — color?
✓
Bloody or serous → pathologic
✓
Milky, non-bloody → endocrine workup
Decision
Pathologic discharge — imaging?
✓
Mammogram (age ≥30) + ultrasound; ductography in some cases
Outcome
Image-guided biopsy of any abnormality; treat per histology
Decision
Palpable lump or skin changes?
✓
No → likely physiologic; pregnancy test, serum prolactin, TSH; consider MRI pituitary
✓
Yes → image-guided workup
Outcome
Galactorrhea workup: prolactin, TSH, pregnancy test; MRI pituitary if elevated prolactin