Galactorrhoea

 

Galactorrhoea is most common in women of reproductive age, but can occur in nulliparous women, menopausal women, and men. In women it may be physiological but in men it is always pathological.  Hyperprolactinaemia is the most common cause, and as many as 90% of women with hyperprolactinaemia have galactorrhoea

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Definition

A large amount of milky discharge from multiple ducts

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Exclude Red Flag Symptoms

Exclude the following red flag symptoms:

  • Breast lump
  • Unilateral blood stained discharge
  • Single duct discharge

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Management

  1. Take a detailed history and undertake an examination to consider cause:
    1. physiological
    2. drugs
    3. thyroid disorder
    4. pituitary tumour (visual field defects/new headaches)
    5. prolactinoma (menstrual disturbance/acne)
  2. Check serum prolactin and TFT:
    1. If prolactin level is very raised (level of 1000) in the absence of pregnancy or breast-feeding refer to an endocrinologist not a breast surgeon

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Desirable Information

Visual field assessment

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Advice and Guidance is being made available for all specialties, and is being provided by consultant specialists at East Kent Hospitals.  To make a request or to check to if a query has been answered, you will need to log in via the electronic Referral System (eRS)

Click here for the "how to access" e-Referral Advice and Guidance Manual for instructions on how to make a request and check responses

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