World Journal of Surgery

, Volume 13, Issue 6, pp 715–720 | Cite as

Periductal mastitis/duct ectasia

  • J. Michael Dixon
Progress Symposium—Benign Breast Disorders: Fibrocystic Disease? Nondisease? or ANDI?

Abstract

Periductal mastitis/duct ectasia affects major breast ducts and is poorly understood. A variety of different terms have been used for this condition and these probably reflect different stages in one disease process.

It appears to be responsible for 1–2% of all symptomatic breast conditions. Although the incidence is higher in postmortem studies, much of what is included as so-called “periductal mastitis” or“duct ectasia” in these studies is duct dilatation, which occurs as part of normal breast involution.

Periductal mastitis appears to be the primary condition with duct ectasia being the outcome. The cause of this periductal mastitis is uncertain, although bacteria, particularly anaerobic organisms, appear to play some role. Clinically, this condition can present with noncyclical mastalgia, nipple discharge, nipple retraction, a subareolar breast mass with or without overlying breast inflammation, a periareolar abscess, or a mammillary fistula.

Antibiotics effective against the organisms isolated from this condition are effective in resolving periareolar inflammation and are useful when combined with surgery in mammillary fistula.

Résumé

La mastite péricanalaire ou ectasie canalaire est une maladie peu connue des canals galactophores majeurs. La variété de termes utilisés pour désigner cette affection témoigne probablement des stades évolutifs de la même maladie.

Cette affection serait responsable de 1 à 2% des toutes les maladies symptomatiques du sein. Bien que l'incidence soit plus élevée dans les études postmortem, bien des cas étiquetés mastite péricanalaire ou ectasie canalaire semblent en fait être une dilatation canalaire qui se voit dans l'involution normale du sein.

La mastite péricanalaire apparaît comme le primans movens; l'ectasie en est le résultat. La cause de la mastite péricanalaire n'est pas connue avec certitude mais il semble que les bactéries, et notamment des anaérobies, jouent un rôle. Cliniquement, cette affection se présente comme des mastalgies non-cycliques, avec écoulements ou rétraction mammelonnaires, masse sousaréolaire avec ou sans inflammation du sein avoisinant, abcès périaréolaire ou fistule mamillaire.

Les antibiotiques adaptés aux organismes retrouvés dans cette affection sont efficaces dans la résolution de l'inflammation périaréolaire et sont également utiles combinés à la chirurgie en cas de fistule mamillaire.

Resumen

La mastitis periductal/ectasia ductal que afecta a los ductos o canalículos mamarios principales es una entidad poco conocida. Una variedad de términos ha sido utilizada para designarla, términos que probablemente reflejan diferentes estadios de un mismo proceso patológico.

La entidad parece ser responsable del 1–2% de todas las entidades sintomáticas que se presentan en los senos. Aunque la incidencia más alta se presenta en exámenes postmortem, mucho de lo que se incluye como“mastitis periductal” o “ectasia ductal” en estos estudios corresponde realmente a la dilatación ductal que ocurre como parte de la involución mamaria normal.

La mastitis periductal parece ser la condición primaria y la ectasia ductal el resultado final. La causa de esta mastitis periductal no aparece clara, aunque las bacterias, especialmente los organismos anaeróbicos, parecen jugar algun papel. Clínicamente esta condición puede presentarse con mastalgia no cíclica, secreción por el pezón, retracción del pezón, masa subareolar con o sin inflamación concomitante del seno, absceso periareolar, o fístula mamilar.

Los antibióticos de demostrada eficacia contra los microorganismos que han sido aislados de cultivos en esta condición clínica son efectivos en cuanto a lograr la resolución de la inflamación periareolar y son de utilidad cuando se combinan con cirugía en casos de fístula mamilar.

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Copyright information

© Société Internationale de Chirurgie 1989

Authors and Affiliations

  • J. Michael Dixon
    • 1
  1. 1.University Department of SurgeryThe Royal InfirmaryEdinburghEngland, UK

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