Mammary Duct Ectasia

Mammary duct ectasia (also called duct ectasia) is a noncancerous breast condition that happens when inflammation causes milk ducts to widen and thicken. Milk ducts are thin tubes in the breast that can carry milk from the lobules to the nipple. 

Changes to the milk ducts sometimes cause swelling or pain, a lump, or nipple discharge. These symptoms are common signs of both breast cancer and less serious breast problems. If you have concerns about changes to your breasts, it’s important to contact your doctor. 

While many people with mammary duct ectasia don’t have any symptoms, those who do may experience:

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  redness, swelling, or inflammation in the nipple

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  nipple discharge, which can range in color from white, green, black, or grey

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  nipple flattening or inversion (the nipple turns inward)

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  a lump or skin thickening near the affected duct

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  pain or tenderness in the nipple or areola that surrounds the nipple

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  fever, due to an infection of the duct

Researchers aren’t sure exactly what causes mammary duct ectasia, but they have some ideas. 

When you’re younger, breast milk ducts are more firm and taut because of the ligaments in the breast supporting them. But when you get older, those ducts can get loose and relaxed, says Monique Gary, DO, a breast surgical oncologist at St. Luke's University Hospital Network Grand View Campus in Sellersville, PA. The ducts can then get wider (dilate), and the walls of the ducts can get thicker. This can make the ducts collapse in on themselves slightly, which can lead to nipple flattening. It can also cause fluid and inflammation to build up. Mammary duct ectasia can happen to anyone, but it’s more common in women around menopause. 

Smoking cigarettes can also cause the milk ducts to widen, which may raise the risk of mammary duct ectasia.

Mammary duct ectasia isn’t a sign of breast cancer, and it doesn’t increase your risk for cancer, either. But because some of the symptoms of mammary duct ectasia can also be signs of breast cancer, it’s important to see a doctor to rule out more serious problems.

If you’re experiencing breast pain that doesn’t improve after taking over-the-counter pain relievers, increased redness or swelling around the nipple, nipple discharge, or fever, contact a doctor right away, as these symptoms can be signs of infection. If other symptoms don’t improve after a couple of weeks, Gary recommends contacting your doctor. 

To diagnose mammary duct ectasia, your primary care doctor will likely give you a breast physical exam before recommending a screening test. These tests may include a mammogram, ultrasound, and/or MRI. 

Your doctor may send you to a breast specialist if they feel your exam or symptoms need more expertise. If there's an area of concern that your healthcare team wants more information about, you may also have a biopsy. A biopsy is when a tiny sample of breast tissue is removed and inspected under a microscope to see if there are cancer cells present. 

If you don’t have any symptoms, it’s possible that you might learn you have mammary duct ectasia during a routine mammogram.

Mammary duct ectasia often resolves without treatment. So if you don’t have symptoms, you don’t need treatment. 

If you do have symptoms, here are some options for relief:

Warm compresses: Apply these to treat pain, redness, and swelling. 

Bras: A supportive bra can take pressure off the nipple, while a moisture-wicking padded bra can absorb any nipple discharge and prevent nipple rubbing and irritation.  

Over-the-counter pain relievers: Acetaminophen and ibuprofen can reduce breast pain and inflammation.

Antibiotics: These may be prescribed to treat an infection of the milk duct, which may cause a fever and/or warmth over the breast.

Surgery: With more severe duct ectasia you might need a surgery to remove the affected milk duct.