Duct ectasia

What is duct ectasia?

Breasts are made up of lobules (milk-producing glands) and ducts (tubes that carry milk to the nipple), which are surrounded by glandular, fibrous and fatty tissue. As women reach the menopause and the breasts age, the ducts behind the nipple get shorter and wider (this is called ectasia). This is a normal breast change and nothing to worry about.

Sometimes a secretion can collect in the widened ducts and their lining can become irritated. It’s also possible for the lining to become ulcerated and painful as well, although this is not common. This condition, which is benign (non-cancerous), is called duct ectasia.

Duct ectasia can also cause a discharge from the nipple, which is usually thick but may also be watery. It can vary in colour and can be either bloodstained or clear.

Sometimes a lump can be felt behind the nipple, or the tissue behind the nipple can become scarred. As the ducts shorten this can eventually pull the nipple inwards so it becomes inverted.

How is it diagnosed?

Your GP is likely to refer you to a breast clinic where you’ll undergo tests for a definite diagnosis.

At the breast clinic you’ll probably have a breast examination, a mammogram and/or ultrasound scan.

If you have discharge from the nipple this may also be tested, especially if it’s bloodstained, to help confirm the diagnosis.

Treatment

In most cases you won’t need any treatment if you have duct ectasia as it is a normal part of ageing and can clear up by itself. It’s important, though, to go back to your GP if you have any new symptoms.

If you continue to have troublesome discharge from the nipple, you may need to have an operation to remove the affected duct or ducts. A microdochectomy will remove only affected ducts, while a Hadfield’s procedure will remove all the major ducts.

Both types of surgery are performed under general anaesthetic and you may be in hospital for the day or overnight.

You’ll have a small stitched wound near the areola and your doctor will tell you how to care for it afterwards.

After the operation your nipple may be less sensitive than before.

The operation should solve the problem, but if it comes back more ducts may need to be removed, as finding all the ducts can sometimes be difficult.

What this means for you

Having duct ectasia does not increase your risk of breast cancer. However, it’s still important to be breast aware and go back to your GP if you notice any other changes in your breasts.