Chapter: Medicine and surgery: Breast disorders

Duct ectasia - Benign disorders of the breast

A benign breast disorder with dilation (ectasia) of the subareolar ducts as part of breast involution with accumulation of cellular debris and inflammation. - Definition, Incidence, Aetiology, Pathophysiology, Clinical features, Complications, Investigations, Management, Prognosis.

Duct ectasia

Definition

A benign breast disorder with dilation (ectasia) of the subareolar ducts as part of breast involution with accumulation of cellular debris and inflammation.

Age

Most common in women approaching the menopause.

Aetiology/Pathophysiology

The dilated ducts are filled with inspissated secretions with a chronic inflammatory response in the surrounding breast tissue. The cause is unknown.

Clinical features

Duct ectasia may be asymptomatic or may cause nipple discharge (often green) and localised tenderness around the areola. Duct fibrosis and shortening can cause nipple retraction without a lump.

Macroscopy/microsopy

The ducts may be dilated as much as 1 cm in diameter and are filled with proteinaceous secretions, lipidladen macrophages and epithelial cells. There is periductal chronic inflammation and fibrosis.

Investigations

Any lump should be investigated using the triple assessment. Although ductography or ductoscopy are possible, they are not routine investigations.

Management

Once the diagnosis is confirmed surgery may be required to exclude malignancy, if the discharge causes distress or to evert the nipple. Treatment is by subareolar excision of the affected ducts.

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Medicine and surgery: Breast disorders : Duct ectasia - Benign disorders of the breast |