Greenish nipple discharge (39/1700)

A lady presents with itching around the breast and greenish foul smelling discharge from the
nipple. She had a similar episode before. What is the most likely dx?

a. Duct papilloma
b. Duct ectasia
c. Breast abscess
d. Periductal mastitis
e. Mammary duct fistula


Discharge from the nipple
1 Blood - stained :
a duct papilloma, when blood arises from a
single duct;
b intraduct carcinoma;
c Paget ’s disease;
d invasive carcinoma (rare).

2 Clear : intraduct papilloma.

3 Multicoloured (often multiduct) : duct ectasia
(discharge commonly yellow, brown or green).

4 Milky : galactorrhoea: may follow lactation but
can also be drug - induced or a manifestation of
hyperprolactinaemia (or, occasionally,

5 Purulent : breast abscess.