I posted a few days ago about a woman who had had a
sebaceous type discharge from her nipples for many
years after weaning.  I had hoped someone here might
have some information.  So far, I have not heard
anything.  One person asked whether it could be a
nipple discharge due to antidepressant medications,
but the patient is not on these.  In fact, she is on
no medications at all.  But the nipple discharge is
very, very different from any discharge I have ever
seen before, which is why I am asking here.

Brief history again.  45 yr old woman w/ subareolar
mass which turned out to be an inflamed sebaceous
cyst.  Expression of contents of cyst (blood, pus and
sebum) resolved the mass and follow-up exam in women's
health dept was normal, as were u/s and mammogram
ordered at followup.  

But the patient had a most unusual finding on exam. 
Both of her nipples produced a thick, cheesy,
fetid-smelling, yellowish-white discharge from the
milk ducts.  As far as I could tell, it was sebaceous
material or sebum just exactly as one would find if
draining a sebaceous cyst.  It wasn't thin or milky
and did not form droplets, but rather it squirted out
in thin strings with a consistency like paste.  Why it
would be coming from both breasts, from all of the
milk pores was a puzzle to me.  The patient stated
that she has had that same discharge for 10+ years
since she weaned her last baby.  Noone ever commented
on it at a physical and she never asked.  

Has anyone seen this before?  And more importantly, is
there any cause for concern?

Catharine Decker, MD
Family Medicine/Urgent Care
Luther Mayo Midelfort Health Systems


       
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