Does Paget disease of the breast cause nipple discharge?

Paget disease starts in the nipple area and may cause fluid to come from the nipple. The discharge may occur with itching, scaling, crusting, redness, soreness, or a change in the nipple shape. These findings can appear together, but discharge by itself does not identify the cause.

Discharge may also be linked to hormonal changes, medicines, infection, a blocked duct, or another breast condition. A clinician considers whether it is spontaneous, comes from one breast or both, and appears clear, milky, or blood-stained.

Book a breast assessment for new, persistent, or spontaneous discharge, particularly when it comes from one nipple or occurs without squeezing. Record its colour, texture, timing, and whether there are skin changes, pain, or a lump.

Do not repeatedly squeeze the nipple to check for fluid, as stimulation can maintain discharge. Bring a list of medicines and explain whether you are pregnant, breastfeeding, or recently stopped breastfeeding.

Seek prompt review for blood-stained or clear discharge from one nipple, discharge with a new lump, or discharge alongside crusting, ulceration, or nipple inversion. Seek urgent help if discharge occurs with fever, severe pain, or rapidly spreading redness.

What features of my discharge matter most? Do I need breast imaging or a tissue sample? Could any of my medicines or hormonal changes explain it?