Red flags & when to go in person for Nipple Discharge - Triage

Audience: adult

Nipple discharge can be caused by various factors, ranging from harmless to signs of more serious conditions. Telemedicine can help evaluate your symptoms, provide guidance, and suggest next steps. However, some signs require prompt in-person medical evaluation. These include discharge that is bloody, occurs without squeezing, is accompanied by a lump or skin changes, or if you experience pain or fever. During a telemedicine visit, your healthcare provider will ask about the color, amount, and timing of the discharge and any other symptoms. This helps determine if further tests or physical exams are needed. Remember, telemedicine is a helpful first step but not a replacement for hands-on examination when red flags are present. If you notice any concerning signs, seek in-person care promptly to ensure proper diagnosis and treatment.

Red flags — go in person / ER

• Bloody nipple discharge without squeezing — seek in-person evaluation promptly.
• New breast lump or thickening felt during self-exam — arrange urgent medical assessment.
• Skin changes on the breast such as redness, dimpling, or ulceration — get immediate in-person care.

What telemedicine can do

• Initial symptom assessment and history taking for nipple discharge.
• Providing education about common causes and self-care advice.
• Determining if symptoms require urgent in-person evaluation.
• Guidance on when to seek further testing or specialist referral.

What telemedicine cannot do

• Physical breast examination to assess lumps or skin changes.
• Performing diagnostic imaging like mammograms or ultrasounds.
• Collecting nipple discharge samples for laboratory analysis.
• Emergency treatment of infections or other urgent breast conditions.

What is Nipple Discharge?

Nipple discharge is any fluid that comes out of the nipple. It can be clear, milky, yellow, green, or bloody. Discharge may happen when squeezing the nipple or occur on its own. Causes range from normal hormonal changes to infections or growths in the breast.

When Telemedicine Can Help

Telemedicine can assist in reviewing your symptoms and medical history. A healthcare provider can help determine if your nipple discharge is likely harmless or if you need further testing. They can guide you on self-care and when to watch for warning signs.

Signs That Need In-Person Care

Certain symptoms should prompt you to see a healthcare provider in person quickly:

Preparing for Your Telemedicine Visit

Before your appointment, note details about your discharge:

Having this information ready helps your provider assess your condition better.

After Your Telemedicine Visit

Your provider may recommend:

Follow their advice carefully and report any worsening symptoms immediately.

How to prepare for your tele-visit

• Note the color, amount, and frequency of nipple discharge.
• Check if discharge occurs spontaneously or only when squeezing.
• Examine breasts for lumps, swelling, or skin changes.
• List any other symptoms like pain, fever, or weight loss.
• Have your medical history and any previous breast problems available.

After your tele-visit

• Follow recommendations for monitoring symptoms at home.
• Schedule an in-person visit if advised by your provider.
• Complete any recommended imaging or laboratory tests.
• Report any new or worsening symptoms immediately.
• Maintain regular breast self-exams and note changes.

FAQs

Is nipple discharge always a sign of cancer?

No. Nipple discharge can have many causes, most of which are not cancer. Common causes include hormonal changes, infections, or benign growths. However, certain types of discharge, especially if bloody or spontaneous, should be evaluated by a healthcare provider.

Can I use telemedicine to diagnose the cause of nipple discharge?

Telemedicine can help assess your symptoms and guide next steps but cannot replace a physical breast exam or imaging tests needed for diagnosis. If red flags are present, an in-person visit is important.

What should I do if my nipple discharge changes in color or amount?

If you notice changes such as new blood in the discharge, increased amount, or discharge without squeezing, contact your healthcare provider promptly for evaluation.

Can infections cause nipple discharge?

Yes. Infections like mastitis can cause nipple discharge, often accompanied by pain, redness, and fever. These usually require in-person medical treatment.

Is nipple discharge normal during breastfeeding?

Yes. Nipple discharge, including milk, is normal during breastfeeding. However, if you notice unusual discharge like blood or pus, or if you have pain or fever, seek medical advice.

Sources

1. Nipple Discharge — MedlinePlus, U.S. National Library of Medicine.
2. Breast Discharge — Mayo Clinic.
3. Breast Cancer Signs and Symptoms — Centers for Disease Control and Prevention (CDC).
4. Evaluation of Nipple Discharge — National Library of Medicine.

This telemedicine guidance is for educational and triage purposes only and is not a substitute for in-person medical care. If you experience any red flag symptoms or worsening condition, seek prompt evaluation by a healthcare professional.