(B)- Mammary Duct Ectasia

Question 1

What is mammary duct ectasia?

Answer 1

Benign condition where there is dilation of large ducts in breasts

Question 2

Who is most affected by mammary duct ectasia?

Answer 2

Perimenopausal women

Question 3

What is a significant risk factor of mammary duct ectasia?

Answer 3

Smoking

Question 4

How does mammary duct ectasia present?

Answer 4

• Nipple discharge, white, grey or green
• Tenderness of pain
• Nipple retraction of inversion
• Breast lump

Question 5

How is mammary duct ectasia diagnosed?

Answer 5

Initial priority is to exclude breast cancer

Triple assessment

Microcalcifications- key finding on mammogram, not specific to mammary duct ectasia though

Question 6

What investigations can be performed for mammary duct ectasia after triple assessment?

Answer 6

Ductography
Contrast injected into abnormal duct, mammogram then used to visualise duct

Nipple discharge cytology
Examining cells in nipple discharge

Ductoscopy
Inserting endoscope into duct

Question 7

What is the management for mammary duct ectasia?

Answer 7

May resolve without treatment

• Reassurance after excluding cancer
• Symptomatic management of mastalgia (supportive bra + warm compresses)
• Antibiotics if infection suspected or present
• Surgical excision (microdochectomy) if problematic