What to know about mammary duct ectasia
Mammary duct ectasia is most common in people who are close to or have already gone through menopause. This condition typically affects females, but there are very rare cases of it developing in males.
In this article, we look at mammary duct ectasia in more detail, including its symptoms and causes and when to see a doctor. We also cover medical treatment and home remedies.
What is mammary duct ectasia?
People who have gone through menopause are more likely to experience mammary duct ectasia.
The breasts consist of mammary ducts and glands called lobules. The lobules produce milk that flows through the mammary ducts into the nipples.
Mammary duct ectasia is when the milk ducts under the nipple become clogged up with fluid. This blockage can occur when the milk ducts get wider, and their walls thicken. There may also be inflammation at the site of the fluid buildup.
The American Cancer Society advise that mammary duct ectasia is a noncancerous, or benign, condition that does not increase the risk of breast cancer. It may cause other symptoms and complications, but these are not generally serious.
Mammary duct ectasia does not always cause symptoms. When symptoms do occur, they can include:
- a green-brown discharge from the nipple
- a lump behind the nipple where the duct has become clogged
- nipple inversion, which is when the nipple turns inward
- pain or tenderness around the clogged duct
- skin reddening over the affected duct
- swelling around the nipple
If an infection develops in the milk duct, it may cause additional signs and symptoms. Doctors refer to this infection as mastitis, and its symptoms include:
- intense pain
- malaise, or generally feeling unwell
- skin redness, which may be in the shape of a wedge
- swelling of the breast
- warm skin around the site of the infection
When to see a doctor
A person should consider speaking to their doctor if breast or nipple changes are persistent, severe, or troublesome.
A person should talk to a doctor if breast or nipple changes are persistent, severe, or worrisome.
Although mammary duct ectasia is a benign condition, and its symptoms often resolve without treatment, it is better to be cautious when new breast symptoms appear. There are some similarities between the symptoms of mammary duct ectasia and those of breast cancer.
People should also see a doctor if they have any of the symptoms of mastitis, especially if these do not begin to improve quickly with home care. Untreated mastitis can lead to an abscess, which is a painful buildup of pus. Abscesses require medical treatment to prevent further complications.
Doctors do not fully understand what causes mammary duct ectasia. However, potential causes and risk factors include:
- Aging. Natural changes to breast tissue occur as people get older. Sometimes, these changes can increase the risk of a duct becoming clogged and inflamed.
- Nipple inversion. When a nipple turns inward, it may change the structure of a milk duct and increase the risk of a blockage.
- Obesity. People who are overweight or have obesity may be more at risk of mammary duct ectasia than those who are at a more healthful weight, according to a 2017 review.
- Smoking. Smoking is a known risk factor for mammary duct ectasia. The results of a study from 2005 suggest that people who smoke are three times more likely to develop this condition than those who have quit smoking or never smoked.
To diagnose mammary duct ectasia, a doctor will ask questions about a person's symptoms and review their medical history. They will usually also perform a breast exam.
The doctor may then recommend one or more of the following tests:
- a mammogram, which is an X-ray of the breast
- an ultrasound scan of the breast tissue
- a biopsy, in which the doctor takes a sample of breast tissue using a thin needle and sends it to a laboratory for examination under a microscope
- analyzing a sample of nipple discharge, especially if it contains blood
People with mammary duct ectasia do not always require treatment. However, if the condition is affecting a person's quality of life, a doctor may recommend treatments to relieve symptoms.
We discuss some of the possible treatment options below:
Over-the-counter (OTC) pain relievers, such as acetaminophen, and anti-inflammatory medications, such as ibuprofen and acetaminophen, may help relieve pain, tenderness, and swelling in the breast. A doctor or pharmacist can provide advice on the benefits and risks of OTC medications.
A doctor may recommend antibiotics for people with symptoms of mastitis that do not get better with home care.
Surgery for mammary duct ectasia is rarely necessary. Doctors usually reserve surgery for people with symptoms that do not respond to medication or home treatments.
Surgery options include:
- a microdochectomy, which is a procedure that removes the blocked milk duct
- a total duct excision, which involves surgically removing all of the main milk ducts from the breast
Doctors usually give people undergoing these procedures a general anesthetic so that they are not awake during the surgery and do not feel any pain.
The surgeon will make a small cut, or incision, in the areola, which is the dark skin around the nipple. They will then remove the duct or ducts and close the wound with stitches. After the procedure, there will be a small scar at the site of the incision, but this should fade over time.
Self-care and home remedies
Sleeping on the side of the body opposite the affected breast may help improve moderate symptoms such as pain.
People with mild to moderate symptoms often find relief from simple home remedies and self-care. These remedies can include:
- applying a warm compress to the sore nipple or breast. Learn how to make a homemade heating pad here.
- wearing a supportive bra to reduce discomfort
- using a disposable or washable breast pad to soak up nipple discharge. Reusable breast pads are available for purchase online.
- sleeping on the side of the body opposite to that of the affected breast
- quitting smoking and losing excess weight, if applicable, which may improve treatment outcomes and reduce the risk of recurrence
- treating mastitis as soon as possible with ice packs or cold compresses and plenty of rest. Ice packs are available for purchase online.
Mammary duct ectasia occurs when a milk duct becomes blocked and clogs up with fluid. It is not a serious condition and does not increase a person's risk of breast cancer. However, it may cause discomfort and can sometimes lead to an infection that requires treatment.
The symptoms of mammary duct ectasia can be similar to some of those of breast cancer, so it is important for people to see a doctor for a breast examination. It is also best to see a doctor if symptoms do not improve with home treatments.
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