Mammary Duct Ectasia

Mammary duct ectasia, also called periductal ectasia or duct ectasia, is a benign (noncancerous) breast condition in which the milk ducts become swollen and clogged.

It’s most common in women who are nearing menopause (marking the time when menstrual periods have stopped for 12 straight months), though it can happen earlier or later, too. It often resolves on its own and does not increase the risk of breast cancer.

This article reviews what mammary duct ectasia is, its symptoms, and how it is diagnosed and treated.

Symptoms of Mammary Duct Ectasia

Mammary duct ectasia often causes no symptoms and is only discovered when another breast problem requires a biopsy (removing a sample of tissue for testing in a lab).

When symptoms do occur, they can be worrisome, as some mimic the symptoms of breast cancer. Symptoms can include redness and pain in the nipple and surrounding area, as well as a discharge that can be of various colors, including black or red. Other symptoms can include:

• A small lump just under the nipple
• Tenderness/irritation of the nipple and areola
• Pink or red color to the nipple and areola
• Thick nipple discharge that is often sticky and dark green or black, though it may also be yellow, white, clear, or even bloody
• Nipple may retract (pull inward)

A bacterial infection called mastitis also may develop in the milk duct, causing breast tenderness, inflammation, and fever with or without chills.

Persistent and untreated duct ectasia could lead to the formation of an abscess, a collection of pus in your breast tissue, that may need to be drained.

What Causes Mammary Duct Ectasia?

Duct ectasia results from the normal changes that occur in breast tissues around menopause. The ducts become shorter and wider, and their walls thicken, which can result in a buildup of fluid and increase their chances of becoming clogged.

Nipple inversion, sometimes due to an underlying breast cancer, can also sometimes cause duct ectasia.

Risk factors for mammary duct ectasia include being female, having obesity, having a history of lactation (breastfeeding), and smoking. Although it is most common in women entering menopause, it can develop in young children and older adults, as well. It sometimes occurs in men, but this is uncommon.

How Is Mammary Duct Ectasia Diagnosed?

Diagnosis usually involves a healthcare provider performing a physical exam, and may require additional tests, such as:

• A breast ultrasound which may show the dilated breast ducts
• A magnetic resonance imaging (MRI) scan to get a more in-depth view of the breast
• Mammography can show calcifications in the region

When the diagnosis is uncertain, an excisional biopsy is required. A pathologist looks at the sample obtained during the procedure under a microscope to make sure there's no evidence of cancerous cells.

Talk to your healthcare provider if you have symptoms of mammary duct ectasia.

How Do You Treat Mammary Duct Ectasia?

Most of the time, mammary duct ectasia resolves without any treatment. Self-care measures like applying warm compresses to your nipple and wearing a supportive bra can help reduce discomfort. If there's evidence of an infection, antibiotics will be prescribed.

It's important to not squeeze the area to increase discharge, as this can increase inflammation and the chance of an infection developing.

If symptoms don't resolve, surgery may be done to disconnect and remove the duct. Known as Hadfield's operation, the procedure takes about 30 minutes and is usually done under general anesthesia through a tiny incision at the edge of your areola. This removal of a single duct will not affect your ability to breastfeed.

Summary

Mammary duct ectasia is a benign breast condition where one or more milk ducts become swollen and clogged. It is most common around menopause but can occur at earlier ages.

Mammary duct ectasia usually gets better on its own with home remedies but sometimes surgery is needed to remove the clogged duct. If you notice any of the symptoms, call your healthcare to have it evaluated.