Mammary duct ectasia

Mammary duct ectasia is characterised by chronic inflammatory and fibrotic changes leading to clogging of debris within the duct. It is of primary importance because of its features mimicking to that of malignancy.

Some publications use this term synonymously with periductal mastitis 7 or plasma cell mastitis 10,11, while others suggest that they are distinct entities with different a different pathogenesis 8,9 .

More common in females in an age group of 50-60 years (i.e. post menopausal). Very rarely seen in males.

  • nipple discharge
  • nipple retraction
  • pain/tenderness
  • palpable mass

Pathological features include chronic periductal inflammatory changes with fibrosis. Inspissation of debris and secretions within the dilated ducts and later calcification of these ductal contents occurs. There is a known association between ductal ectasia and smoking 12.

Mammography
  • dilated linear branching densities in subareolar region
  • calcifications are rod like or cigar or broken needle like which are pointing towards the nipple
Ultrasound
  • dilated, fluid filled subareolar ducts with moving echogenic particulate matter (debris) on real time sonography without mass
  • these findings often mimic an intraductal tumour (papilloma)
MRI

On T1 and T2 weighted images it appears as dilated increased signal intensity branching ducts converging towards the nipple without an overlying mass. Hyperintense signals are due to thick proteinaceous fluid or blood.

It was first described by Haagensen in the year 1951 3.

For dilated ducts see: differential diagnosis of dilated ducts on breast imaging.


Breast imaging and pathology
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Article Information

rID: 25691
System: Breast
Sections: Gamuts, Pathology
Tags: cases, refs
Synonyms or Alternate Spellings:
  • Duct ectasia of breast
  • Breast duct ectasia
  • Ectasia of mammary ducts
  • Periductal mastitis

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