Mammary Duct Ectasia

What is mammary duct ectasia?

Mammary duct ectasia (or duct ectasia) is a noncancerous breast condition causing inflammation (swelling) and thickening of your milk ducts. Your breasts are made up of lobules (glands that make milk), ducts (tubes that carry milk to your nipple) and other tissues. As you age, your milk ducts shorten and widen. This causes your breasts to become sore or for fluid to build up and clog your duct. Most people recover without treatment, but if symptoms don’t go away, your healthcare provider may prescribe antibiotics or remove the affected duct with surgery.

Who is likely to have mammary duct ectasia?

Anyone assigned female at birth (AFAB) can have mammary duct ectasia. The condition is more common among women and people AFAB who are approaching menopause (around age 50 or older). It can also occur after menopause. Duct ectasia can happen in men and people assigned male at birth (AMAB), but this is rare.

Is mammary duct ectasia cancerous?

No, it’s noncancerous (benign) and doesn’t increase your risk for developing breast cancer. However, some symptoms of duct ectasia are associated with symptoms of breast cancer. It’s a good idea to discuss any changes in your breasts with your healthcare provider.

What causes mammary duct ectasia?

Mammary duct ectasia results from inflammation (swelling). This inflammation causes a milk duct within your breast to widen and thicken. As inflammation worsens, milk ducts become blocked, and fluid builds up behind the blockage. It’s common for milk ducts and breast tissue to change as a person reaches the age of menopause, although it can happen before or after menopause.

While the exact cause of this inflammation is unknown, researchers think that bacterial infection of the milk ducts make it more likely for a person to develop mammary duct ectasia. Smoking cigarettes may be associated with duct ectasia.

What are the symptoms of mammary duct ectasia?

Some people have no symptoms of duct ectasia. In those who do, the most common symptoms are:

• Breast tenderness.
• Thick or sticky nipple discharge that may be green, black or tinged with blood.
• Redness on the skin of your breast.
• Inverted nipple (nipple turning inward).
• A lump behind your nipple.

Mammary duct ectasia may cause lumps to form in your breast just behind your nipple. Lumps develop because of scar tissue that forms around inflamed milk ducts. The lump may be confused with breast cancer, but it isn’t cancer.

What does mammary duct ectasia feel like?

Not everyone experiences nipple or breast pain from mammary duct ectasia — it’s rare to have pain. More common symptoms that you may feel are tenderness, soreness or a lump behind your nipple.

What does duct ectasia look like?

Some people with mammary duct ectasia have a thick, gooey nipple discharge. This isn’t always the case. Others notice a red spot or a change in their nipple (like their nipple turns suddenly turning inward).

How is mammary duct ectasia diagnosed?

Your healthcare provider diagnose mammary duct ectasia in a few ways:

• Breast exam: Your provider uses their fingers to examine your breast tissue while you lie down with one arm over your head. They feel for lumps and watch for discharge.
• Ultrasound: Ultrasound uses sound waves to create a picture of interior body structures. This helps your provider better see the inside of your breasts.
• Mammogram: Mammography machines use X-rays to view any changes in your breast and get a better look at your milk ducts.
• Magnetic resonance imaging scan (MRI): MRIs use radio waves and powerful magnets to create detailed images of the inside of your breasts.
• Biopsy: Your healthcare provider removes a small sample of breast tissue from the affected breast and looks at the tissue under a microscope. If you have a lump in your breast, your provider biopsies the lump to check for cancer.

Can duct ectasia be seen on mammogram?

Yes, a mammogram (breast X-ray) is one way healthcare providers test for mammary duct ectasia.

How do you treat mammary duct ectasia?

Mammary duct ectasia often resolves on its own with no treatment. Some people find relief by simply applying warm compresses to the affected breast several times a day.

Other things you can do to help manage symptoms include:

• Wearing breast pads (or nursing pads) to absorb nipple discharge.
• Sleeping on the unaffected breast or your back to prevent additional pressure and discomfort.
• Wearing a well-fitting and supportive bra.

If a bacterial infection causes your condition, your provider will prescribe antibiotic medications. Some people find relief from inflammation and discomfort with over-the-counter (OTC) pain relievers like ibuprofen.

If a milk duct remains blocked or leaks discharge despite treatment, your provider can remove the inflamed duct (or ducts) surgically.

Surgery for duct ectasia

Surgery to remove the affected duct or ducts involves a surgeon making an incision (a cut) along the edge of your areola (the colored skin around your nipple) to remove the abnormal duct or ducts. They’ll use stitches to close the incision, which may leave a tiny scar.

What complications are associated with mammary duct ectasia?

If left untreated, a bacterial infection in your milk duct may cause more widespread infection and tissue damage. This could lead to a condition called mastitis. Contact your healthcare provider if you notice signs of infection such as fever or chills.

Does mammary duct ectasia go away?

Yes. For some people, mammary duct ectasia goes away without treatment or with at-home treatment like a warm compress.

Can mammary duct ectasia be prevented?

There’s no way to prevent mammary duct ectasia. Some research suggests certain lifestyle factors may increase your likelihood of developing this condition. These factors include:

• Obesity (having a body mass index, or BMI, of 30 or more).
• Smoking cigarettes.
• Having unmanaged diabetes.

What is the outlook for people with mammary duct ectasia?

Most people recover from mammary duct ectasia without treatment. If you require medical treatment, your recovery should be uncomplicated. Surgery is rarely needed.

What questions should I ask my healthcare provider?

If you think you may have mammary duct ectasia, you may have many questions, including:

• How can I treat my condition at home?
• What signs or symptoms should I watch out for that might indicate my condition is worsening?
• How will I know that mammary duct ectasia is causing my lump and not breast cancer?
• Which treatments will be most effective for my symptoms?

A note from Cleveland Clinic

Mammary duct ectasia is a condition that causes your milk ducts to become inflamed and thick. While it can cause uncomfortable symptoms, it rarely becomes serious or requires surgery. Most find relief with pain relievers, antibiotics or at-home treatments like applying warm compresses. It’s common to mistake symptoms of duct ectasia like nipple discharge and lumps for breast cancer. Talk to your healthcare provider about any changes in your breasts to ensure you’re not dealing with a potential cancer diagnosis.