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. The lining can also become ulcerated and painful as well, although this is not common. This is a benign (not cancer) condition called duct ectasia.
Duct ectasia can also cause a discharge from the nipple, which is usually thick but may also be watery. The discharge can vary in colour and can be either clear or bloodstained.
Sometimes a lump can also 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. These may include a breast examination, a mammogram and/or ultrasound scan. You can find out more about these investigations in our information about referral to a breast clinic.
If you have discharge from the nipple this may also be tested, especially if it’s bloodstained, to help confirm the diagnosis.
In some circumstances a procedure called a breast duct endoscopy may be used. This uses a very fine flexible tube (scope) which is inserted through the nipple to look inside the lining of the duct/s. Tissue and fluid samples can be taken for examination under a microscope. This investigation is not widely available but may be carried out as part of a clinical trial.
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.
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, regardless of how soon these occur after your diagnosis of duct ectasia.