Periductal Mastitis Women’s Clinic What is Periductal Mastitis? The breasts are made up of lobules (milk-producing glands) and ducts (tubes that carry milk to the nipple), which are surrounded by fatty tissue and supportive tissues. Sometimes the ducts under the nipple become inflamed and infected. This inflammation is periductal mastitis.
People who smoke may have an increased risk of being affected by periductal mastitis, because substances in cigarette smoke can damage the ducts behind the nipple. Nipple rings and piercing can increase the chances of infecton and make periductal mastitis more difficult to treat.
Periductal mastitis is non-cancerous. It can affect women of all ages but is more common in younger women.
Diagnosis After breast examination, mammogram (breast x-ray) and/ or ultrasound scan (which creates an image of the breast using highfrequency sound waves), may be ordered by your doctor, so that a definite diagnosis can be made.
Periductal mastitis can make the breasts feel hot and tender to the touch, and the skin may appear red. It can also result in discharge from the nipple. The fluid secreted can be either bloody or non-bloody. Periductal mastitis is a key cause of infection around the nipple and the infected ducts may feel painful. Sometimes a lump can be felt behind the nipple, or the tissue behind the nipple can become scarred. This can pull the nipple inwards so it eventually becomes inverted. An abscess (a collection of pus) may develop.
If the breast is very tender or if you are under the age of 35, you are more likely to have an ultrasound scan rather than a mammogram. This is because the breast tissue in younger women is too dense to give a clear image on a mammogram. If you have discharge from the nipple, especially if it is bloodstained, this may also be tested, to help confirm the diagnosis.
Treatment Some individuals may not need any treatment for periductal mastitis as it may clear up by itself. It is important to go back to your doctor if you have any new symptoms as the condition can reoccur. You will be treated with antibiotics to clear up any infection, and may wish to take painkillers such as Paracetamol if your breast feels painful. If you have developed an abscess, your doctor will decide upon the best way to treat it, This may involve using a fine needle to draw off (aspirate) the pus. This would be done in the clinic using a local anaesthetic. If your periductal mastitis does not clear up after taking antibiotics or if it reoccurs, you may need to have an operation to remove the affected duct(s). You may be offered microdochectomy (removal of just the affected duct) or the Hadfield’s procedure (removal of all the major ducts). The operation will be done under general anaesthesia. You will have a
small wound near the areola (darker area of the skin around the nipple) with stitches in it. The doctor/nurse will provide advice on appropriate care for the wound. If your breast feels painful after the operation you may wish to take painkillers such as Paracetamol. The operation will leave a small scar but this will fade over time. After the operation your nipple may become less sensitive than before. The operation should treat the condition. However, if the inflammation returns, more ducts may need to be removed. Research has shown that smoking can slow down the healing process of periductal mastitis. It is advisable for you to stop smoking if you smoke. What does this means to you? Having periductal mastitis does not incease your risk of breast cancer. However, it is still important to be aware of your breast condition by doing regular examinations. Consult your doctor if you notice any further changes in your breasts.
Yishun Health is a network of medical institutions and health facilities in the north of Singapore, under the National Healthcare Group. Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.
WC.PE.08.1118