Mammary duct ectasia
Mammary duct ectasia
Description, Causes and Risk Factors:
Mammary duct ectasia is a condition in which the lactiferous duct becomes blocked or clogged. Mammary duct ectasia can mimic breast cancer. It is a disorder of premenopausal age.
Your breasts are made up of connective tissues that include a system of milk ducts — tiny passages that carry milk to the nipples. Mammary duct ectasia occurs when a milk duct beneath the nipple becomes wider (dilated), blocked or clogged with a sticky substance and inflamed.
Experts don't know exactly what causes mammary duct ectasia. Some speculate the cause to be associated with:
Smoking. Cigarette smoking may be associated with widening of milk ducts, which can lead to inflammation and, possibly, mammary duct ectasia.
Nipple inversion. A newly inverted nipple may obstruct milk ducts, causing inflammation and infection. A nipple that's newly inverted also could be a sign of a more serious underlying condition, such as cancer.
Breast tissue changes due to aging. As you age, the composition of your breast tissue changes from mostly glandular to mostly fatty in a process called involution. These normal breast changes can sometimes lead to blockage of a milk duct and the inflammation associated with mammary duct ectasia.
Mammary duct ectasia affects primarily middle-aged to elderly parous women. Smoking is a risk factor. One study found that smokers were three times more likely to develop the condition than non-smokers and the risk appeared to be proportional to the duration of smoking.
Although mammary duct ectasia often does not cause signs and symptoms, you may experience:
Redness of the nipple and sometimes the surrounding area.
A dirty white, greenish or black nipple discharge from one or both nipples.
A breast lump or thickening near the clogged duct.
A nipple that's turned inward (inverted).
Tenderness in the nipple or surrounding breast tissue.
Imaging will be required.Non-invasive methods are preferable - given the findings are most likely benign. The choice of modality needs to be individualized according to the patient and will depend on a number of factors, including the age of the patient, breast size and whether or not a lump is palpable. Despite advances in investigative techniques, the incidence of false-negatives remains high.
A diagnosis can be made by a combination of:4
Ductography: this method is occasionally used as an adjunct to mammography in parous women with a unilateral nipple discharge. A small amount of contrast medium is injected into a milk duct and a mammogram performed.
Ductal lavage and cytology: cytology of cells obtained by ductal lavage has provided promising results but more research is needed.Doubts have been cast on the diagnostic value of cytology of nipple discharge smears.Only 20% of high-risk women with ductal lavage atypia have atypical hyperplasia or malignancy on subsequent excision.
Ultrasound: this is used as an adjunct to mammography. Higher resolutions and the introduction of Doppler have facilitated the differentiation between benign and malignant lesions.
A mammogram is a useful screening tool, particularly in older women. It is especially sensitive in picking up microcalcification and should be performed whenever complicated, malignant and uncommon forms of mastitis are suspected.
Mammary duct ectasia often improves without treatment. If your symptoms are bothersome, however, treatment options may include:
Surgery. If antibiotics and self-care methods don't work, the affected milk duct may be surgically removed. This procedure is done through a tiny incision at the edge of the colored tissue around your nipple (areola). However, surgery rarely is needed for mammary duct ectasia.
Antibiotics. Your doctor may prescribe a 10- to 14-day course of antibiotics to treat any infection caused by mammary duct ectasia. Even if your symptoms greatly improve or disappear completely, it is important to take the entire course of medication. While waiting for the antibiotics to take effect, you may want to take a mild pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others), as needed for breast discomfort. Follow your doctor's recommendation on which pain reliever is best for you.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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