Benign Ductal Disease

Question 1

Define ductal ectasia:

Answer 1

When the duct becomes blocked and secretions stagnate causing nipple discharge +/- nipple retraction +/- lumps

Question 2

Define intraductal papilloma:

Answer 2

Non-cancerous growth which occurs within the milk ducts - solitary or in multiples.

Question 3

Aetiology/risk factors:

Answer 3

In duct ectasia central ducts become dilated with ductal secretions due to blockage of the lactiferous ducts.

Near menopause age

Question 4

Epidemiology:

Answer 4

Occurs in women in menopause.

Question 5

Symptoms:

Answer 5

Duct ectasia - green/brown/bloody discharge from the nipple

History of breast discomfort or pain

Swelling or lump

Intraductal papilloma - small lump near the nipple (if it is multiple then will be further from the nipple and smaller)

Question 6

Signs

Answer 6

Focal and diffuse nodularity of the breast

Discharge

Dumpling

Peau d’orange

Enlarged axillary lymph nodes

Question 7

Investigations:

Answer 7

Triple assessment:

• Clinical examination
• Mamogram (two view)
• Ultrasound in younger pts <35 yrs

Cytology via fine needle aspiration

Histology via excision biopsy