Involutional mammary duct ectasia and periductal mastitis

Tedeschi, Luke G.; Ahari, Saeed; Byrne, John J.

doi:10.1016/0002-9610(63)90140-5

Cited by 81 publications

(3 citation statements)

References 9 publications

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“…The main ducts are arranged radially and two to three ducts can be identified merging with the main duct. Duct diameters above two to three millimetres are considered enlarged and indicative of ductal ectasia [ 26 , 27 ] or may be related to mastalgia [ 28 ], however a range of duct diameters from 0.6 to 4.4 mm have been measured in asymptomatic women [ 28 ]. Ducts of the non-lactating breast are generally not distorted by compression, unless containing fluid such as blood, and can be distinguished from vessels by the use of Colour Doppler Imaging.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound imaging of the lactating breast: methodology and application

Geddes

2009

Int Breastfeed J

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Ultrasound imaging has been used extensively to detect abnormalities of the non-lactating breast. In contrast, the use of ultrasound for the investigation of pathology of the lactating breast is limited. Recent studies have re-examined the anatomy of the lactating breast highlighting features unique to this phase of breast development. These features should be taken into consideration along with knowledge of common lactation pathologies in order to make an accurate diagnosis when examining the lactating breast. Scanning techniques and ultrasound appearances of the normal lactating breast will be contrasted to those of the non-lactating breast. In addition ultrasound characteristics of common pathologies encountered during lactation will be described.

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Section: Introductionmentioning

confidence: 99%

Ultrasound imaging of the lactating breast: methodology and application

Geddes

2009

Int Breastfeed J

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“…The etiological factors and pathogenesis of non-puerperal mastitis are not clear, and reports suggest that hyperprolactinemia caused by long-term oral antipsychotics [7] and pituitary adenomas [8] is directly related to this disease, which may be caused by chronic in ammation and brosis caused by dilated ducts and concentrated secretions leading to the occurrence of this disease.Pathological section analysis by Tedeschi [9] in patients with clinical plasma cell mastitis revealed that the material accumulated in the lactiferous ducts was similar to those chemical stimuli that escaped into the surrounding tissues, mainly some fatty acids, as well as a small mixture of phospholipids and cholesterol.It was also found that the composition of nipple discharge in the non-lactating state was similar to that in lactating milk, and the levels of free fatty acids, triglycerides, cholesterol, and phospholipids in nipple secretions during nonlactation were higher than those in colostrum [10].Rodman [11] used rabbits as the experimental subjects to inject pancreatized milk into the breasts of rabbits for modeling, but there was no speci c experimental procedure in the literature, and the experiment could not be repeated; Li Daofang [12] found that patients with ductal ectasia syndrome mainly presented with abnormal secretion of estrogen, luteinizing hormone and prolactin, and non-pregnant New Zealand female rabbits were used for the experiment and the model was successfully established. However, the intervention method of exogenous estrogen and progesterone administration resulted in abnormal secretion of other hormones at the same time, and the design of the in uencing factors was not rigorous enough.In this experiment, the model was induced by metoclopramide, which can directly act on hypothalamic dopamine receptors to induce an increase in prolactin levels, and we intervened the animals with metoclopramide to increase only prolactin levels.When modeling, the milk injected locally into the mammary gland of normal rats was obtained from Wistar lactating dams, so that the hormone in uencing factors of modeling were single, while the injected milk was also obtained from homologous, with controllable variables, which better simulated the pathogenesis of the disease.…”

Section: Discussionmentioning

confidence: 98%

Preliminary study on the construction of animal model for non-puerperal mastitis

Ma¹,

Chen²

2021

Preprint

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Objection: This qualitative study explored the key factors affecting the occurrence of non-puerperal mast (NPM） and the construction of an animal model which is closer to the characteristics of the disease.Background: The etiological factors and pathogenesis of NPM are unknown, and the incidence, misdiagnosis rate and recurrence rate are high. Previously reported modeling methods vary, reproducibility is poor, and disease characteristics cannot be well characterized, so new animal models are urgently needed for research.Methods: In this study, using female Wistar rats to construct a non-puerperal mastitis animal model by intraperitoneal injection of metoclopramide to simulate hyperprolactinemia + autologous milk injected into the mammary gland to simulate ductal secretions. Results: Pathological results showed that 2 weeks after injection in group C (intraperitoneal injection of metoclopramide for 2 weeks + breast injection of maternal milk mixture twice) and group D (intraperitoneal injection of metoclopramide for 2 weeks + breast injection of maternal milk mixture three times), lipid stasis, periductal inflammation, and massive plasma cell and lymphocyte infiltration were observed,similar to the lesions in patients with human plasma cell mastitis. Conclusions: We believe that we can can establish a non-puerperal mastitis model by altering prolactin levels and ductal secretion stasis in rats.

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“…It is still unclear whether duct dilatation (duct ectasia) is caused by chronic inflammation (periductal mastitis), or whether duct ectasia occurs first, and the inflammation results from stasis of secretions. Nevertheless, it is generally agreed that ductal dilatation and stasis are fundamental abnormalities, 2,6 and that these are very common changes in the general population, being noted in around 10% of women undergoing breast surgery for unrelated problems. 7 Similar studies have shown that both aerobic and anaerobic bacteria can be cultured from between 50% and 90% of normal patients having cosmetic breast surgery.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Mammary Duct Fistula by Fistulectomy and Saucerization

et al. 2005

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This study was designed to assess the efficacy and long-term outcome of fistulectomy and saucerization for treatment of mammary duct fistulae. Mammary fistula is a chronic condition that represents the final step in what has been termed "mammary duct associated inflammatory disease sequence." The treatment is primarily surgical and may include healing by secondary intention or primary closure with or without antibiotics. Reported series are small and often include variable surgical strategies applied without consistency. A consecutive series of 53 patients who had 59 mammary duct fistulae were treated by fistulectomy with saucerization. The median age was 32 years. Wounds were allowed to heal by secondary intention and antibiotics were not used. We reviewed the case records to establish the incidence of recurrent fistula and the time to complete healing. The long-term cosmetic outcome was determined by a postal survey. After a median follow-up of 6 years there had been no relapse in 92%. There was significant delay in healing in six cases (range: 10 to 30 weeks). Thirty-eight patients (83%) gave a definite history of regularly smoking between 10 and 20 cigarettes a day. Two thirds of the patients were either pleased or satisfied with the final cosmetic result of the surgery, but more than 90% said that it left them with some distortion of the nipple. Fistulectomy and saucerization achieves long-term cure in the majority of patients with mammary duct fistula, but it results in some degree of distortion of the nipple. The strong relationship between smoking and the occurrence of mammary duct fistulae is again demonstrated.

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Involutional mammary duct ectasia and periductal mastitis

Cited by 81 publications

References 9 publications

Ultrasound imaging of the lactating breast: methodology and application

Ultrasound imaging of the lactating breast: methodology and application

Preliminary study on the construction of animal model for non-puerperal mastitis

Treatment of Mammary Duct Fistula by Fistulectomy and Saucerization

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