Table Evaluation of Nipple Discharge History History of present illness should include the following: Whether the current discharge is unilateral or bilateral What its color is and whether it is bloody or blood-tinged How long it has lasted Whether it is spontaneous or occurs only with nipple stimulation Whether a mass or breast pain is present Review of systems should seek symptoms suggesting possible causes, including the following: Fever: Mastitis or breast abscess Cold intolerance, constipation, or weight gain: Hypothyroidism Amenorrhea, infertility, headache, or visual disturbances: Pituitary tumor Ascites or jaundice: Liver disorders Nonlactational mastitis may be periductal mastitis, idiopathic granulomatous mastitis, or tuberculous mastitis.