Nipple discharge and fear of cancer

Case scenario

Jane, a 34-year-old woman, comes to see you. She is concerned about her nipple discharge, which she later demonstrates to you (Figure). The discharge has been present for ‘about a year’. She wasn’t worried about it at first, but there’s more of it now, her breasts are lumpy and she’s worried she may have cancer.

Jane had menarche at the age of 11, regular periods (mostly with a contraceptive pill), and two pregnancies when she was aged 28 and 32 – with healthy infants whom she breastfed for three and five months respectively.