91 P - Periductal mastitis and mammary duct ectasia - two stages of the same disease?

Abstract

This paper deals with a disease known under several names: obliterative mastitis, plasma cell mastitis, periductal mastitis, comedomastitis, mammary duct ectasia, which seem to define different stages of the same illness. Out of 67 cases of benign breast diseases recorded in our hospital during a 3-year interval, 15 cases were diagnosed as periductal mastitis or mammary duct ectasia. The dominant pathological findings in younger patients (17–40 years) were periductal infiltration with plasma cells, lymphocytes or polymorphic cells, while in older patients (over 52) duct ectasia and nipple retraction were prevalent, being frequently associated with periductal infiltration. Microbiological examination of the intraoperative samples showed different germs in most cases. Thus antibiotic prophylaxis was justifted in our cases. Our study supports the idea that this disease begins with a silent ductal infection with periductal infiltration, and ends with chronic inflammation and fibrosis with consequent duct ectasia. Therefore, periductal mastitis, non-puerperal mastitis and duct ectasia arc stages of the same pathological process. Due to the clinical similarity with breast cancer, treatment by sectorectomy becomes mandatory. This paper deals with a disease known under several names: obliterative mastitis, plasma cell mastitis, periductal mastitis, comedomastitis, mammary duct ectasia, which seem to define different stages of the same illness. Out of 67 cases of benign breast diseases recorded in our hospital during a 3-year interval, 15 cases were diagnosed as periductal mastitis or mammary duct ectasia. The dominant pathological findings in younger patients (17–40 years) were periductal infiltration with plasma cells, lymphocytes or polymorphic cells, while in older patients (over 52) duct ectasia and nipple retraction were prevalent, being frequently associated with periductal infiltration. Microbiological examination of the intraoperative samples showed different germs in most cases. Thus antibiotic prophylaxis was justifted in our cases. Our study supports the idea that this disease begins with a silent ductal infection with periductal infiltration, and ends with chronic inflammation and fibrosis with consequent duct ectasia. Therefore, periductal mastitis, non-puerperal mastitis and duct ectasia arc stages of the same pathological process. Due to the clinical similarity with breast cancer, treatment by sectorectomy becomes mandatory.