Duct ectasia

• Mammary duct ectasia may be seen in up to 25% of normal female breasts
• Patients usually present with nipple discharge, which may be from single or multiple ducts (usually present age >50 years)
• The discharge is often thick and green
• Duct ectasia is a normal varient of breast involution and is not the same condition as periductal mastitis

Periductal mastitis

• Present at younger age than duct ectasia
• May present with features of inflammation, abscess or mammary duct fistula
• Stongly associated with smoking
• Usually treated with antibiotics, abscess will require drainage

Intraductal papilloma

• Growth of papilloma in a single duct
• Usually presents with clear or blood stained discharge originating from a single duct
• No increase in risk of malignancy

Breast abscess

• Lactational mastitis is common
• Infection is usually with Staphylococcus aureus
• On examination there is usually a tender fluctuant mass
• Treatment is with antibiotics and ultrasound guided aspiration
• Overlying skin necrosis is an indication for surgical debridement, which may be complicated by the development of a subsequent mammary duct fistula.