Mammary duct ectasia

Mammary duct ectasia (ek-TAY-zhuh) occurs when one or more milk ducts beneath your nipple widens. The duct walls may thicken, and the duct may fill with fluid. The milk duct may become blocked or clogged with a thick, sticky substance. The condition often causes no symptoms, but some women may have nipple discharge, breast tenderness or inflammation of the clogged duct (periductal mastitis).

Mammary duct ectasia most often occurs in women during perimenopause — around age 45 to 55 years — but it can happen after menopause, too. The condition often improves without treatment. If symptoms persist, you may need antibiotics or possibly surgery to remove the affected milk duct.

Though it's normal to worry about any changes in your breasts, mammary duct ectasia and periductal mastitis aren't risk factors for breast cancer.

Mammary duct ectasia often doesn't cause any signs or symptoms, but some people experience:

• A dirty white, greenish or black nipple discharge from one or both nipples
• Tenderness in the nipple or surrounding breast tissue (areola)
• Redness of the nipple and areolar tissue
• A breast lump or thickening near the clogged duct
• A nipple that's turned inward (inverted)

A bacterial infection called mastitis also may develop in the affected milk duct, causing breast tenderness, inflammation in the area around the nipple (areola) and fever.

Signs and symptoms of mammary duct ectasia may improve on their own.

Make an appointment with your doctor if you notice changes in your breasts — such as a new breast lump, spontaneous nipple discharge, skin redness or inflammation, or an inverted nipple — that are persistent or that worry you.

Your breasts are made up of connective tissues that include a system of tiny passages that carry milk to the nipples (milk ducts). Mammary duct ectasia occurs when a milk duct beneath the nipple widens. The duct walls may thicken and fill with fluid, becoming blocked or clogged with a sticky substance. Inflammation may result.

Experts don't know exactly what causes mammary duct ectasia. Some speculate the cause to be associated with:

• Breast tissue changes due to aging. As you age, the composition of your breast tissue changes from mostly glandular to mostly fatty in a process called involution. These normal breast changes can sometimes lead to a blocked milk duct and the inflammation associated with mammary duct ectasia.
• Smoking. Cigarette smoking may be associated with widening of milk ducts, which can lead to inflammation and, possibly, mammary duct ectasia.
• Nipple inversion. A newly inverted nipple may obstruct milk ducts, causing inflammation and infection. A nipple that's newly inverted could also be a sign of a more serious underlying condition, such as cancer.

Complications of mammary duct ectasia are usually minor and often more bothersome than serious. These may include:

• Nipple discharge. Nipple discharge caused by mammary duct ectasia can be frustrating. Fluid leaking from your nipples can cause embarrassing wetness and staining on your clothes.
• Breast discomfort. Mammary duct ectasia can cause redness, swelling and tenderness around your nipples.
• Infection. An inflammatory infection (periductal mastitis) may develop in the affected milk duct, sometimes causing pain in or around the nipple, a general feeling of illness or a fever. Persistent redness and worsening pain could be a sign of a bacterial infection and can lead to an abscess — a collection of pus in your breast tissue — which may require a procedure to drain it.
• Concern about breast cancer. When you notice a change in your breast, you may worry that it's a sign of breast cancer, especially if you develop a hard lump around the nipple or areola. Having a history of mammary duct ectasia doesn't increase your risk of breast cancer. Still, it's important to see your doctor promptly anytime you notice breast changes.