Mammary Duct Ectasia

Mammary duct ectasia is a benign (non-cancerous) breast condition characterized by the dilation of the milk ducts in the breast. It is also known as periductal mastitis or plasma cell mastitis.

Causes and Risk Factors

The exact cause of mammary duct ectasia is not well understood, but it is thought to be related to hormonal changes, aging, and possibly an autoimmune response. The condition is more common in women over the age of 40 and those who have had a history of smoking.

Symptoms

The symptoms of mammary duct ectasia may include:

• Pain or tenderness in the breast, particularly around the nipple-areolar complex
• Nipple discharge, which can be greenish or blackish in color
• Inversion of the nipple (nipple retraction)
• Periareolar abscesses or fistulas (abnormal connections between the ducts and the skin)
• Breast swelling or redness

Diagnosis

The diagnosis of mammary duct ectasia is typically made based on a combination of clinical evaluation, imaging studies, and biopsy. The following tests may be used to diagnose the condition:

• Clinical breast examination
• Mammography (breast X-ray)
• Ultrasound
• Breast MRI (magnetic resonance imaging)
• Ductography (a specialized imaging test that uses a contrast agent to visualize the milk ducts)
• Breast biopsy (to rule out cancer or other conditions)

Treatment

The treatment of mammary duct ectasia depends on the severity of symptoms and the presence of any associated complications. The following treatments may be used:

• Antibiotics to treat any underlying infections
• Pain management medications, such as analgesics or anti-inflammatory agents
• Surgical procedures, such as duct excision or microdochectomy (removal of the affected duct), to relieve symptoms and prevent further complications
• Smoking cessation counseling, as smoking is thought to exacerbate the condition

Prognosis and Complications

The prognosis for mammary duct ectasia is generally good, with most women experiencing significant improvement in symptoms after treatment. However, some women may experience persistent or recurrent symptoms, and there is a small risk of developing breast cancer or other complications, such as:

• Chronic breast pain
• Nipple retraction or inversion
• Breast abscesses or fistulas
• Scarring or deformity of the breast