Duct Ectasia of the Breast

What are the symptoms?

Common symptoms of duct ectasia of the breast include:

• redness or tenderness around your nipple and areola
• an inverted nipple (a nipple that turns inward)
• unusual nipple discharge
• pain in the affected nipple (this symptom isn’t as common as the other symptoms)

You may also feel a lump behind your nipple due to an infection or accumulation of scar tissue.

What causes it?

Duct ectasia is usually caused by aging. It’s common in women who are approaching menopause or going through menopause. However, some women develop duct ectasia after going through menopause.

As you age, the milk ducts under your areola become shorter and wider. This can cause fluid to collect in the ducts, which can clog them and lead to irritation.

Having an inverted nipple or smoking can also increase your risk of developing duct ectasia.

How is it diagnosed?

Your doctor can usually diagnose duct ectasia by doing a basic breast exam. They’ll have you place one arm over your head. They will then use two fingers to examine your breast tissue. This can help them feel for any obvious lumps or look for other symptoms, such as discharge.

They may also have you get a mammogram, which is an X-ray of your breast. You may also get an ultrasound. This imaging technique uses high-frequency sound waves to produce a detailed image of the inside of your breast. Both of these imaging techniques can help your doctor get a better view of your breast ducts and rule out any other potential causes of your symptoms.

If it looks like you might have an infection, your doctor might also test a sample of discharge from the affected nipple for signs of infection.

If your doctor finds a lump behind your nipple, they may also perform a biopsy. In this procedure, you doctor takes a small tissue sample from your breast with a thin, hollow needle and examines it for any signs of cancer.

How is it treated?

Duct ectasia often clears up on its own without any treatment. Try not to squeeze the affected nipple. This can lead to more fluid production.

If the discharge doesn’t stop, your doctor might recommend surgery, including:

• Microdochectomy. In this procedure, your doctor removes one of your milk ducts.
• Total duct excision. In this procedure, your doctor removes all of your milk ducts.

Both procedures are usually done by making a small cut near your areola. The excision only requires a few stitches, resulting in a low risk of lingering scars. Your surgery may be performed under general anesthesia as an outpatient procedure, or it may require a short hospital stay.

After surgery, the affected nipple might turn inward or lose some sensation.

Home remedies

While some cases of duct ectasia require surgery, most resolve on their own. In the meantime, there are a few things you can do at home to relieve any discomfort, including:

• taking nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil)
• applying a warm compress to the affected nipple
• using soft breast pads inside of your bra to absorb any discharge
• avoiding sleeping on the affected side

Are there any complications?

Some cases of duct ectasia of the breast result in mastitis, an infection of your breast tissue.

Signs of mastitis include:

• pain
• redness
• warmth
• fever
• chills

Try to see your doctor as soon as you notice signs of an infection. Most cases of mastitis respond well to oral antibiotics. However, untreated mastitis can lead to an abscess that needs to be surgically drained.

What’s the outlook?

While duct ectasia can be uncomfortable, it’s usually a harmless condition that resolves on its own. As it goes away, there are several home remedies you can try to help manage your symptoms. In some cases, you may need surgery to remove a clogged milk duct. This is usually a quick, safe procedure. Contact your doctor right away if you notice any signs of infection so you can avoid any other complications, like an abscess.