Breast Duct Ectasia

Introduction

• Description: Duct ectasia is the dilation of the ducts of the breast with the inspissation of normal secretions, arising from chronic intraductal and periductal inflammation.

• Prevalence: Relatively common in asymptomatic form. Up to one-third of cases of pathologic nipple discharge.

• Predominant Age: Older than 50 years, although it may occur in children and adolescents.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Chronic intraductal and periductal inflammation.

• Risk Factors: Mastitis, breast abscess, chronic irritation.

Signs and Symptoms

• Thick gray to black sticky nipple discharge

• Pain and nipple tenderness

• Thickening is often present and may be difficult to distinguish from cancer (firm, rounded, and fixed, with skin retraction)

• Nipple retraction common (ductal ectasia is the most common cause of an acquired nipple inversion)

Diagnostic Approach