Discharge of fluid from the nipple is very common. Fortunately, most nipple discharge is benign, meaning that it is rarely due to a cancer. Nonetheless, all new nipple discharge should be investigated. The lactiferous ducts that come from the milk-producing breast lobules concentrate into the nipple, and anywhere from five to fifteen will open onto the surface. The nipple discharge can be of variable colour, consistency and volume. It may be from one nipple or both. In addition to investigations, Dr Lancashire needs to take an extensive history and perform a thorough examination to help determine what the likely cause may be. Surgery for nipple discharge There are two main types of surgery that breast surgeons perform with respect to the ducts in the breast. Both of these procedures require a general anaesthetic. 1. Microdochectomy This is the removal of a single lactiferous duct. It is often possible for a specialist breast surgeon to identify a single duct that the nipple discharge is coming from. Occasionally more than one duct maybe removed during this procedure. 2. Total duct excision A total or ‘central’ duct excision is the removal of all of the ducts under the nipple. If there are many ducts involved, or if a microdochectomy is not successful at controlling the discharge, Dr Lancashire may discuss a total duct excision with you. The choice of operation can be complex and Dr Lancashire will explain the rationale and potential side effects of the procedures in detail if they are recommended in your situation.