Mammary duct ectasia
It is characterized by the dilation of the mammary ducts affecting mainly greater ones, galactophore and segmental to varying degrees of pericanalicular inflammation (periductal mastitis) with progressive fibrosis that can generate investment or retraction of the nipple. Affects women between the ages of 30 to 80 years, average age 44 years, and rarely to men.
The etiology is unknown, It is spoken of probable causal factors such as atrophy and involution breast of the postmenopausal, periductales inflammatory processes (periductal mastitis) nicotine addiction, long-term treatments with Phenothiazine and symptoms of hyperprolactinemia, which were associated with duct ectasia .
Ectasia Ductal de Conductos Galactoforos
The first symptoms are Nipple discharge (a spontaneous and intermittent liquid) that may be clear, turbidity, yellowish, grayish or bloody. It affects approximately 20 percent of the cases, Usually at this stage abnormalities do not occur in the subareolar Palpation,in the most advanced cases are noted a progressive subareolar induration in the shape of tumor masses “in the Shape of worms”.
Ectasia ductal
These ectatic ducts may suffer Cystic dilatation, which are occupied by fat secretions, cytodetritus and retained blood, sometimes with bacterial colonization staphylococcus aureus, bacteroids, enterococci, streptococcus anaerobic (approximately 50 per cent of the cases).
Later in some cases ,when the cyst wall breaks, and eliminate its contents into the surrounding tissue, generates significant inflammatory reactions (mastitis periductal) sometimes granulomatous, often recurrence, generating pain and inflammation at the level of the involved area, which is, generally , congestive and swollen at the areolar level, and It could evolve to an abscess, fistulas, granulomas and fibrous changes with nipple retraction or inversion.
Between 23 and 40 per cent of the patients with duct ectasia remain asymptomatic.
Ectasia Ductal Lobulillar
The ectasic secretion is alkaline with cellular debris and haematic retained material, can generate calcifications which are observed in the mammography, in different appearances, from linear and branching calcifications, speculated microcalcifications mass, thick and annular formations, etc.
The diagnosis is obtained by ultrasound, mammography, galoctografía and cytologic studies of the fluid that seeps out of the nipple.
The treatment is usually surgical, with reseccion of the affected area (reseccion of milk ducts or pipes central).
The duct ectasia may be associated with:
1) papilloma
2) ductal carcinoma insitu
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