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December 13, 1976

Incidence of Galactorrhea-Reply

Author Affiliations

Veterans Administration Hospital Albuquerque, NM

JAMA. 1976;236(24):2747. doi:10.1001/jama.1976.03270250017015

Dr Kemmann refers to several studies in which the incidence of galactorrhea among women of childbearing age was low. A similar number of studies can be cited in which the incidence of galactorrhea was substantially higher, ranging from 12% to 46%.1-4 The striking differences in the reported incidences of galactorrhea can be attributed to two factors. The technique of the breast examination is crucial to the detection of occult galactorrhea. A systematic examination, using both hands to exert pressure from the periphery (where the alveolar cells are synthesizing milk) toward the nipple in a perimetric fashion, will yield a higher incidence of galactorrhea than a casual squeeze of the subareolar tissue. The second factor yielding contrasting results is the definition of galactorrhea. All studies exclude bloody or purulent secretions, but the definition of "milk-like" is tenuous. Some investigators exclude cloudy or opalescent secretions, which are not obviously