Mammary duct ectasia Flashcards
What is mammary duct ectasia?
A benign condition where there is dilation of the large ducts in the breasts.
Ectasia = dilation
In mammary duct ectasia there is inflammation in the ducts, leading to intermittent discharge from the nipple. What colour does the discharge usually appear?
May be white, grey or green.
Who does mammary duct ectasia mainly affect?
Perimenopausal women
What is a significant risk factor for mammary duct ectasia?
Smoking
Typical presentation for mammary duct ectasia?
Nipple discharge
Tenderness or pain
Nipple retraction or inversion
A breast lump (pressure on the lump may produce nipple discharge)
Mammary duct ectasia may be discovered incidentally on mammogram. True/false?
True
What is initial priority for investigations in mammary duct ectasia?
Initial priority is to exclude breast cancer as a diagnosis.
Carry out triple assessment:
- Clinical history and examination
- Imaging (mammogram or ultrasound)
- Histology (core needle biopsy or fine needle aspiration)
What other investigations can be carried out for mammary duct ectasia?
Ductography – contrast is injected into an abnormal duct, and mammograms are performed to visualise the duct
Nipple discharge cytology – examining the cells in a sample of the nipple discharge
Ductoscopy – inserting a tiny endoscope (camera) into the duct
Management of mammary duct ectasia?
May resolve without any treatment.
Management depends on the individual patient:
Reassurance after excluding cancer may be all that is required
Symptomatic management of mastalgia (supportive bra and warm compresses)
Antibiotics if infection is suspected or present
Surgical excision of the affected duct (microdochectomy) may be required in problematic cases
Mammary duct ectasia is associated with an increased risk of breast cancer. True/false?
False
No increased likelihood of breast cancer.
