Duct Ectasia

Question 1

Define duct ectasia.

Answer 1

Duct ectasia is a condition in which occurs when a milk duct beneath the nipple widens, the duct walls thicken and the duct fills with fluid. This is the most common cause of greenish discharge.

Question 2

Explain the aetiology/risk factors of duct ectasia.

Answer 2

Aging, mostly women approaching menopause but some women develop this after menopause.
Inverted nipple
Smoking

Question 3

Summarise the epidemiology of duct ectasia.

Answer 3

Women approaching menopause generally get duct ectasia because as they age, the milk ducts under the areola get shorter and wider. It can very rarely occur in men.

Question 4

Recognise the presenting symptoms of duct ectasia. Recognise the signs of duct ectasia on physical examination.

Answer 4

Dirty white, greenish or black nipple discharge from one or both nipples
Tenderness in the nipple or surrounding breast tissue
Erythema
A breast lump or thickening near the clogged duct
Inverted nipple

Question 5

Identify appropriate investigations for duct ectasia and interpret the results.

Answer 5

Breast exam
Mammogram
USS
Sample of discharge for culture/cystoscopy
FNA