Benign Ductal Disease

Question 1

What is Duct ectasia?

Answer 1

When ducts become blocked + secretions stagnate, causing nipple discharge +/- nipple retraction +/- lump.

Question 2

Describe the aetiology of duct ectasia

Answer 2

Central ducts become dilated with ductal secretion due to a blockage of the lactiferous ducts

Question 3

Describe the epidemiology of Benign Ductal Disease

Answer 3

Occurs in women at menopause

Question 4

List 3 features of Duct ectasia

Answer 4

“Cheesy” green/ brown/ bloody nipple discharge
Swelling or lump
Hx of breast discomfort/pain

Question 5

Describe appearance of Intraductal papilloma

Answer 5

Small lump near nipple, discharge.

Multiple papillomas are smaller + occur further away from nipple.

Question 6

List 3 signs of Benign Ductal Disease

Answer 6

Focal or diffuse nodularity of breast
Discharge
Features of malignancy absent

Question 7

What is an Intraductal papilloma?

Answer 7

Non-cancerous growth which occurs within the milk ducts: can be solitary or multiple growths.

Question 8

What investigations are performed for Benign Ductal Disease?

Answer 8

Triple assessment
Clinical Examination
Imaging
Cytology/ Histology

Question 9

What forms of imaging are used when investigating benign ductal disease?

Answer 9

Mammography (2-view): benign lumps are less likely to be calcified
US in younger patients (< 35 yrs)

Question 10

What cytological/ histological investigations are performed in benign ductal disease?

Answer 10

FNA: sent for cytological analysis

Excision Biopsy: sent for histological analysis