Excision of the ductal system of the breast: a new modification

Excision of the major ductal system of the breast as described by Hadfield in 1960 is associated with several complications, such as loss of sensation in many women, nipple retraction in 10% and necrosis of aerola-nipple complex. In order to reduce such complications, we have modified the classical Hadfield technique. The basic difference is advancement of the aerola-nipple complex as a flap into a new bed immediately above the incision across the upper half of aerola-skin junction. The results of 46 operations performed for 33 patients (13 patients had bilateral operation) were satisfactory. After a mean follow up of 3.5 years, loss of sensation occurred in two patients (4%), epithelial necrosis of the upper half of the aerola in one patient (2%), and recurrence of discharge in another patient (2%). No episodes of wound infection or nipple retraction were reported in this study. The results demonstrate the effectiveness of this technique as an appropriate alternative to classical Hadfield operation.