Is Breast Duct Ectasia a Serious Problem?

Breast duct ectasia is common in middle-aged women. Some people know little about breast duct ectasia. So is breast duct ectasia a serious problem? If breast duct ectasia is accompanied by nipple discharge, it is likely to lead to other breast diseases, which requires serious attention. Surgery is recommended if necessary. Let’s talk about the specific diagnosis of breast duct ectasia.

Mammary duct ectasia is a chronic breast disease with a long course and complex and diverse lesions. In the past, there was insufficient understanding of this disease and it has been referred to by many different names. Recently, some scholars believe that plasma cell mastitis is not an inevitable process of mammary duct ectasia. Plasma cell mastitis has its own characteristic morphology and clinical manifestations, and it is regarded as a special type of mastitis. The diagnosis of this disease mainly relies on detailed inquiry into the medical history, understanding its clinical course, considering its age of onset, and combining the following points to often make a correct diagnosis.

1. This disease is more common in non-lactating or menopausal women over 40 years old who often have a history of lactation disorders. The lesions are usually confined to one side, but both breasts may be affected simultaneously.

2. Nipple discharge is sometimes the first and only symptom of this disease. Single or multiple orifice discharge may be seen, which may be serous or bloody in nature. Compression of the mammary gland at multiple locations can cause secretions to overflow from the nipple. The lesions often involve a large number of milk ducts and can occupy more than half of the areola. Nipple discharge is often intermittent, sometimes coming and sometimes not.

3. Sometimes a breast lump is the first symptom. The lump is often located deep in the areola with unclear edges. In the early stages, the lump is adhered to the skin, which may resemble breast cancer.

4. If the lump has turned into pus, it is often accompanied by enlarged axillary lymph nodes on the same side, but the texture is soft and tender. As the disease progresses, the enlarged lymph nodes may gradually subside.

5. Due to the proliferation of fibrous tissue in the mammary duct wall and around the duct and the inflammatory reaction, the duct shortens and the nipple retracts. Sometimes due to local skin edema, it may appear as "orange peel-like".

6. X-ray breast ductography can clearly show dilated ducts and cysts to understand the extent of the lesions.

7. Fine needle aspiration cytology examination of the tumor can often extract pus-like material or find neutrophils, necrotic material and a large number of plasma cells, lymphocytes and cell residual nuclei, which is very helpful for the diagnosis and differential diagnosis of this disease. Pathological examination after tumor resection is the most reliable basis for diagnosis.