Periductal mastitis

This is an inflammatory condition that affects the larger milk ducts close to the nipple. It occurs typically in young women in their 30s.

It causes redness, swelling and pain around the nipple/areolar area. There can also be nipple discharge.

Smoking is thought to be a causative factor and it is important to stop smoking as part of the initial treatment. Women who continue to smoke have ahigh incidence of recurrence.

Treatment is initially with antibiotics.

An abscess may form and this will require drainage preferably with ultrasound guided needle aspiration, but occasionally with open incision and drainage in theratre.

A hard lump can develop near the nipple and will require proper assessment to distinguish it from a cancer lump.

A small opening can develop on the skin that oozes discharge intermittently. This is called a mammillary fistula and is due to an abnormal opening between one of the inflamed ducts and the skin. This may need to be excised surgically.