Sequelae of subareolar mammary duct excision

Mammary duct ectasia and periductal mastitis have been largely described as one clinical syndrome. Recently this interrelation has been studied and the link questioned. Subareolar mammary duct excision is a well-defined surgical technique but it has complications. In this study we aimed to identify any aetiological factors of this condition and to assess the outcome of the surgical treatment. Fifty-two women of an average age of 42 years (range 23–73 years) who had undergone Adair/Urban operation for mammary duct ectasia between 1979 and 1986 were studied retrospectively by sending them a letter which enquired about history, postoperative course and degree of satisfaction with the treatment. Thirty women replied. Fifteen (50%) had a history of atopia and there was a history of autoimmune disorders in 7 (23%). Among a variety of complaints reported, a change in sensation was experienced by 20 (66%): of the nipple by 13 (43%) and of the breast by 7 (23%). The overall satisfaction with treatment and cosmesis was excellent in 15 (50%) and good in 8 (27%). Atopia as a possible contributing factor deserves more attention. Subareolar mammary duct excision, although efficacious, is not devoid of complications although it produces a satisfactory outcome for most patients. There is a high incidence of altered sensation after this operation.