Periductal Mastitis
| A | 1,2,3 True & 4,5 False | |
| B | 1,2,3 False & 4,5 True | |
| C |
1,2,5 False & 3,4 True |
|
| D |
1,2,5 True & 3,4 False |
| A |
1,2,3 True & 4,5 False |
|
| B |
1,2,3 False & 4,5 True |
|
| C |
1,2,5 False & 3,4 True |
|
| D |
1,2,5 True & 3,4 False |
Duct ectasia- This is a dilatation of the breast ducts, which is often associated with periductal inflammation.
- Nipple discharge (of any color), a subareolar mass, abscess, mammary duct fistula and/or nipple retraction are the most common symptoms.
Ductal papilloma- Patients with symptoms often present with spontaneous bloody or clear nipple discharge.
Fibroadenoma– They arise from hyperplasia of a single lobule and usually grow up to 2-3 cm in size.
Chronic breast abscess- A chronic intramammary abscess, which may follow inadequate drainage or injudicious antibiotic treatment, is often a very difficult condition to diagnose.
Carcinoma of Breast-
- Change in breast size or shape
- Skin dimpling or skin changes
- Recent nipple inversion or skin change, or nipple abnormalities
- Single-duct discharge, particularly if blood-stained
- Axillary lump
Discharges from the nipple (the principal causes are in bold)
Discharge from the surface
Paget’s disease
Skin diseases (eczema, psoriasis)
Rare causes (e.g. chancre)
Discharge from a single duct
Blood-stained:
Intraductal papilloma
Intraductal carcinoma
Duct ectasia
Serous (any color):
Fibrocystic disease
Duct ectasia
Carcinoma
Discharge from more than one duct
Blood-stained:
Carcinoma
Ectasia
Fibrocystic disease
Black or green:
Duct ectasia
Purulent:
infection
Serous:
Fibrocystic disease
Duct ectasia
Carcinoma
| A |
Simple mastectomy |
|
| B |
Microdochotomy |
|
| C |
Lobectomy |
|
| D |
Hadfield operation |
Ans is d i.e. Hadfield operation
- Duct ectasia is dilatation of lactiferous ducts often associated with periductal inflammation, the pathogenesis of which is unknown.
- The dilated ducts are filled with brown or green coloured secretions. These fluids cause an irritant reaction in the surrounding tissue leading to periductal mastitis or even abscess and fistula formation. This may lead in some cases to a chronic indurated mass beneath the areola, mimicking a carcinoma. Eventually fibrosis develops which may cause nipple retraction.
- Clinical features- Nipple discharge of any colour, abscess, mammary duct fistula, subareolar mass and nipple retraction.
- Treatment
- Antibiotic therapy may be tried but surgery is mostly required to cure this notoriously difficult condition. Surgery consists of excision of all the major ducts (Hadfield’s operation)
Surgery for periductal mastitis –
| A |
Hadfield’s operation |
|
| B |
Patey’s mastectomy |
|
| C |
Modified radical mastectomy |
|
| D |
None of the above |
Ans. is ‘a’ i.e., Hadfield’s operation
