Is nipple discharge always a malignant finding?

• A. Yes
• B. No; may be normal and benign
• C. Only in men
• D. Only with cancer in late stages

Answer: (B)

Nipple discharge is not inherently a sign of cancer; many cases are normal or benign. Hormonal fluctuations, pregnancy, lactation, or nipple stimulation can cause discharge that is bilateral, non-bloody, and transient, which patients and clinicians commonly regard as physiologic.

What raises concern is the pattern: spontaneous, unilateral, persistent discharge—especially if it is bloody or clear—often prompts further evaluation for possible ductal pathology or malignancy, and may be accompanied by a palpable lump or skin changes. In practice, imaging is guided by this pattern and the patient’s age: ultrasound is typically used to assess the ducts and look for intraductal lesions in suspicious cases, while mammography is added based on age and risk. So, while cancer is one possible cause, most nipple discharge is benign or physiologic, making the statement not always malignant the best choice.