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Tests and diagnosis
By Mayo Clinic staffFinding the underlying cause of galactorrhea can be a complex task because there are so many possibilities.
Testing may involve:
- A physical exam, during which your doctor may try to express some of the fluid from your nipple by gently squeezing or pressing the area around your nipple to determine if the nipple discharge can be reproduced. Your doctor also checks for breast lumps or other suspicious areas of thickened breast tissue.
- Analysis of fluid discharged from the nipple. Your doctor may do a simple test on the fluid to see whether any blood is present in the fluid.
- A blood test, to check for the amount of prolactin in your system. If your prolactin level is elevated, your doctor might also check your thyroid-stimulating hormone (TSH) level.
- A pregnancy test, to exclude — or confirm — pregnancy as a possible cause of the nipple discharge.
- Mammography, ultrasound or both, to generate images of your breast tissue, if your doctor finds a breast lump or other suspicious breast tissue during your physical exam and to evaluate the area behind the nipple.
- Magnetic resonance imaging (MRI) to check for a tumor or other abnormality of your pituitary gland, if your blood test reveals elevated prolactin levels.
If your doctor suspects medication use as the cause of galactorrhea, you might be instructed to stop taking the medicine for a short time, during which your doctor can assess this possible cause.
References
- Lobo RA. Hyperprolactinemia, galactorrhea, and pituitary adenomas: Etiology,
- differential diagnosis, natural history, management. In: Katz VL, et al., eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby; 2007. http://www.mdconsult.com/das/book/body/202383887-3/1002403495/1524/257.html#4-u1.0-B978-0-323-02951-3..50042-X_1261. Accessed May 24, 2010.
- Ferri FF. Galactorrhea. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/das/book/body/202383887-3/1002403495/2088/252.html#4-u1.0-B978-0-323-05609-0..00016-2--sc0010_5179. Accessed May 24, 2010.
- Snyder PJ. Causes of hyperprolactinemia. http://www.uptodate.com/home/index.html. Accessed May 24, 2010.
- Mancini T, et al. Hyperprolactinemia and Prolactinomas. Endocrinology and Metabolism Clinics of North America. 2008;37:67.
- Snyder PJ. Clinical manifestations and diagnosis of hyperprolactinemia. http://www.uptodate.com/home/index.html. Accessed May 24, 2010.
- Snyder PJ. Treatment of hyperprolactinemia due to lactotroph adenoma and other causes. http://www.uptodate.com/home/index.html. Accessed May 24, 2010.
- Iglehart JD. Diseases of the breast. In: Townsend CM, et al. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/202388075-8/0/1565/325.html?tocnode=54737836&fromURL=325.html#4-u1.0-B978-1-4160-3675-3..X5001-1--section7_1642. Accessed May 24, 2010.
- Pruthi S (expert opinion). Mayo Clinic, Rochester, Minn. June 3, 2010.
- Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. June 8, 2010.
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