The following symptoms and complaints may indicate galactorrhea (abnormal breast milk discharge):
Leading symptom
- Galactorrhea (spontaneous secretion of milk from the breast).
Classification of galactorrhea
| Grade | Description |
| I | Only a few drops expressible (squeezable) |
| II | At least 1 ml of liquid expressible |
| III | Spontaneous milk secretion at times |
| IV | Constant discharge of milk flow |
In younger patients with bilateral secretion (mammillary secretion), physiological galactorrhea is usually present.
Warning signs (red flags)
- Woman + period disturbance (disturbance of the rhythm of menstruation):
- Oligomenorrhea (the interval between bleeding is > 35 days and ≤ 90 days, i.e., bleeding occurs too infrequently).
- Amenorrhea (no menstrual bleeding until 15 years of age (primary amenorrhea) or no menstrual bleeding for more than three months (secondary amenorrhea))
→ think of: Hyperprolactinemia (abnormal prolactin elevation); prolactinoma (possibly also visual disturbances, nausea (nausea)/vomiting).
- Woman > 50 years + new onset galactorrhea → think of: malignant neoplasm.
- Purulent secretion → think of: Mastitis (inflammation of the mammary glands) or an abscess (encapsulated collection of pus).
- Green or brownish secretion → think of: Ductasia (dilated, congested milk ducts) or fibrocystic mastopathy (benign changes in the mammary gland).
- Hemorrhagic (bloody) galactorrhea: unilateral and spontaneous bloody, serous or watery secretion → think of:
- Papilloma (relatively common benign epithelial tumor).
- More rarely also: ductal carcinoma in situ (DCIS) or Paget’s disease of the nipple (form of malignant neoplasia (malignant neoplasm) of the mamma (breast));
- Postmenopausal women → think of: Mammary carcinoma (breast cancer).
- Note: > 90% of cases of hemorrhagic galactorrhea have a benign (benign) cause
- Man + galactorrhea → medical clarification required! (Exception: pubescent boy)
