Periductal mastitis is a condition where lactiferous ducts in the breast are distended and filled with amorphous eosinophilic material and foam cells, with concomitant presence of severe periductal chronic inflammation. In the literature it is also found under synonyms such as mastitis obliterans, plasma cell mastitis or comedomastitis.
This condition is still often confused with mammary duct ectasia, but the latter is considered a separate condition that affects older women and that is characterized by subareolar duct dilatation and less active periductal inflammation process.
Pathogenesis of the disease
Current evidence points to smoking as the most important risk factor in the etiology of periductal mastitis. Approximately 90% of women …show more content…
Associated symptoms include central noncyclical breast pain and purulent nipple discharge.
Moreover, acute episodes of the disease usually cause transient episodes of nipple retraction that resolve on its own as the inflammation abates. Nevertheless, acute forms of the disease can progress further to chronic periductal mastitis and, finally, to periductal fibrosis and permanent nipple retraction.
In approximately one out of five individuals with periductal mastitis, subareolar breast abscess occurs, which is an infectious nonreversible process. Purulent material usually drains spontaneously, while a recurrent periareolar fistula is seen as a complication in 20% of all cases.
Diagnosis and management of periductal mastitis
Triple assessment is usually pursued in the diagnosis of periductal mastitis, which is an umbrella term that encompasses ultrasound examination (to differentiate inflammation from abscess formation), mammography (which reveals an opaque mass of ducts) and clinical examination that reveals skin indentation. Furthermore, microbiologic evaluations are pursued on any discharge or fluid
This condition is still often confused with mammary duct ectasia, but the latter is considered a separate condition that affects older women and that is characterized by subareolar duct dilatation and less active periductal inflammation process.
Pathogenesis of the disease
Current evidence points to smoking as the most important risk factor in the etiology of periductal mastitis. Approximately 90% of women …show more content…
Associated symptoms include central noncyclical breast pain and purulent nipple discharge.
Moreover, acute episodes of the disease usually cause transient episodes of nipple retraction that resolve on its own as the inflammation abates. Nevertheless, acute forms of the disease can progress further to chronic periductal mastitis and, finally, to periductal fibrosis and permanent nipple retraction.
In approximately one out of five individuals with periductal mastitis, subareolar breast abscess occurs, which is an infectious nonreversible process. Purulent material usually drains spontaneously, while a recurrent periareolar fistula is seen as a complication in 20% of all cases.
Diagnosis and management of periductal mastitis
Triple assessment is usually pursued in the diagnosis of periductal mastitis, which is an umbrella term that encompasses ultrasound examination (to differentiate inflammation from abscess formation), mammography (which reveals an opaque mass of ducts) and clinical examination that reveals skin indentation. Furthermore, microbiologic evaluations are pursued on any discharge or fluid