Unusual Bumps and Discharge on the Areola - Obstetrics and Gynecology

Nipple discharge of foreign material?

Hello Dr.
Chang, I am now in the first year of junior high school.
Earlier this year, I noticed a small protrusion on the areola of my right breast, which is slightly smaller than my nipple.
When I squeezed it, a white, semi-solid liquid resembling pus came out.
After a few days of squeezing, I noticed that it would still produce similar fluid.
I didn't pay much attention to it, but a few days ago while showering, I found another similar protrusion on the areola of my right breast.
Out of curiosity, I squeezed it again and got a similar substance.
Upon checking, I found that in addition to the original one, there are now three spots from which I can squeeze out fluid, and there is also a hard lump in my right breast.
Since fifth grade, when I started developing, I have had this hard lump, and it hurts when I press on it—only on the right side; the left side does not have these issues.
Is this normal? Why is there fluid coming out? What could it be?

Jie, 10~19 year old female. Ask Date: 2015/11/25

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your symptom description, it is more likely that you are experiencing folliculitis or sebaceous gland inflammation.
The lump could be due to developing breast tissue or other reasons.
I recommend that you consult a breast surgeon or a gynecologist for evaluation and examination.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2015/11/25

More Info

It sounds like you are experiencing some concerning symptoms related to your breast, particularly on the areola of your right breast. Based on your description, you have noticed a raised bump that produces a white, semi-solid discharge when squeezed, along with some hardness and pain in the area. Let's break this down to better understand what might be happening.

Firstly, the presence of a bump on the areola that produces discharge can be attributed to several potential causes. One common reason for such symptoms in adolescents is the development of sebaceous cysts or ductal ectasia. Sebaceous cysts are benign lumps filled with a thick, oily substance that can occur when a sebaceous gland becomes blocked. Ductal ectasia occurs when a milk duct beneath the nipple dilates, fills with fluid, and thickens, which can lead to discharge.

The fact that you mentioned the discharge is similar to pus and that you have experienced pain and hardness in the area raises a few considerations. It is essential to differentiate between benign conditions and those that may require further evaluation. In some cases, an infection or inflammation of the breast tissue, known as mastitis, can occur, particularly if there is a blockage in the ducts. This condition can lead to swelling, pain, and discharge.

Since you have mentioned that these symptoms are only present on the right side and that you have had hard lumps since fifth grade, it is crucial to have these symptoms evaluated by a healthcare professional. While many breast changes during puberty are normal due to hormonal fluctuations, the presence of persistent lumps, especially those that are painful or produce discharge, should not be ignored.

Here are some steps you should consider taking:
1. Consult a Healthcare Provider: It is essential to schedule an appointment with a doctor, preferably a pediatrician or a breast specialist. They can perform a physical examination and may recommend imaging studies, such as an ultrasound, to assess the lumps and any underlying issues.

2. Avoid Squeezing the Bumps: While it may be tempting to squeeze the bumps to see if they produce discharge, this can lead to irritation or infection. It is best to leave them alone until you have been evaluated by a healthcare professional.

3. Monitor Symptoms: Keep track of any changes in the size of the bumps, the amount of discharge, or any new symptoms such as increased pain, redness, or swelling. This information can be helpful for your doctor.

4. Discuss Your Concerns: When you see your doctor, be sure to express all your concerns, including the pain, the discharge, and the fact that these symptoms are only present on one side. This information will help them make a more accurate diagnosis.

In summary, while some breast changes during puberty can be normal, the symptoms you are experiencing warrant a professional evaluation to rule out any potential issues. Early assessment and intervention can help ensure that any necessary treatment is provided promptly. Remember, it’s always better to be cautious when it comes to your health, especially with changes in your body.

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