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Mammary duct ectasia

Mammary duct ectasia (ek-TAY-zhuh) occurs when a milk duct beneath your nipple becomes wider (dilated), the duct walls thicken and the duct fills with fluid. The milk duct can then become blocked or clogged with a thick, sticky substance. The condition often causes no symptoms, but some women may have nipple discharge, breast tenderness or inflammation of the clogged duct (periductal mastitis).

Your chance of developing mammary duct ectasia — with or without inflammation — increases with age. Mammary duct ectasia usually improves without treatment. However, if symptoms persist despite self-care measures, you may need antibiotics or possibly surgery to remove the affected milk duct.

Though it's normal to worry about any changes in your breasts, mammary duct ectasia and periductal mastisis aren't risk factors for breast cancer.

Symptoms Causes Complications

Although mammary duct ectasia often doesn't cause signs and symptoms, you may experience:

  • A dirty white, greenish or black nipple discharge from one or both nipples
  • Tenderness in the nipple or surrounding breast tissue
  • Redness of the nipple and sometimes the surrounding area
  • A breast lump or thickening near the clogged duct
  • A nipple that's turned inward (inverted)

A bacterial infection called mastitis also may develop in the affected milk duct and cause inflammation in the area around the nipple (areola) and fever. Signs and symptoms of mammary duct ectasia usually improve on their own.

When to see a doctor

It's important for your doctor to promptly evaluate any changes in your breasts to rule out breast cancer. If you have symptoms of mammary duct ectasia — especially unusual nipple discharge — make an appointment with your doctor for evaluation.

Your breasts are made up of connective tissues that include a system of milk ducts — tiny passages that carry milk to the nipples. Mammary duct ectasia occurs when a milk duct beneath the nipple becomes wider (dilated), blocked or clogged with a sticky substance and inflamed.

Experts don't know exactly what causes mammary duct ectasia. Some speculate the cause to be associated with:

  • Breast tissue changes due to aging. As you age, the composition of your breast tissue changes from mostly glandular to mostly fatty in a process called involution. These normal breast changes can sometimes lead to blockage of a milk duct and the inflammation associated with mammary duct ectasia.
  • Smoking. Cigarette smoking may be associated with widening of milk ducts, which can lead to inflammation and, possibly, mammary duct ectasia.
  • Nipple inversion. A newly inverted nipple may obstruct milk ducts, causing inflammation and infection. A nipple that's newly inverted also could be a sign of a more serious underlying condition, such as cancer.

Complications of mammary duct ectasia are usually minor and often more bothersome than serious. These may include:

  • Nipple discharge. Nipple discharge caused by mammary duct ectasia can be frustrating. Fluid leaking from your nipples can cause embarrassing wetness and staining on your clothes.
  • Breast discomfort. Mammary duct ectasia can cause redness, swelling and tenderness around your nipples.
  • Infection. A bacterial infection (periductal mastitis) may develop in the affected milk duct, sometimes causing you to have pain in or around your nipple or to feel ill and have a fever. Untreated infection could lead to an abscess — a collection of pus in your breast tissue — which may require surgical drainage.
  • Concern about breast cancer. When you notice a change in your breast, you may worry that it's a sign of breast cancer, especially if you develop a hard lump around a milk duct affected by mammary duct ectasia. While it's important to get signs and symptoms checked out promptly, remember that mammary duct ectasia does not increase your risk of breast cancer.
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