Donald R Lannin1. 1. Department of Surgery, Yale University School of Medicine, P.O. Box 208062, New Haven, CT 06520, USA. donald.lannin@yale.edu
Abstract
BACKGROUND: Recurring subareolar abscess and lactiferous duct fistula are frequently difficult to manage. METHODS: Personal experience with 67 cases treated during the past 22 years is reviewed. RESULTS: There were 38 cases of subareolar abscess and 29 of lactiferous duct fistula. Thirty-three patients had resolution with antibiotics and needle aspiration or with incision and drainage,but 34 patients required definitive duct excision. Eight patients had duct excision through circumareolar incisions, and 5 of these had prolonged healing problems or recurrence within 1 year. Twenty-six patients had duct excision by placing a probe into the duct and radially excising an elliptical area of the nipple and areola like a "slice of pie," and these all healed primarily (P <0.001). CONCLUSIONS: Approximately half of the patients with subareolar abscess can be managed medically, but the other half will require definitive duct excision. A radial elliptical incision with primary closure results in excellent cosmesis and low long-term recurrence rates.
BACKGROUND: Recurring subareolar abscess and lactiferous duct fistula are frequently difficult to manage. METHODS: Personal experience with 67 cases treated during the past 22 years is reviewed. RESULTS: There were 38 cases of subareolar abscess and 29 of lactiferous duct fistula. Thirty-three patients had resolution with antibiotics and needle aspiration or with incision and drainage,but 34 patients required definitive duct excision. Eight patients had duct excision through circumareolar incisions, and 5 of these had prolonged healing problems or recurrence within 1 year. Twenty-six patients had duct excision by placing a probe into the duct and radially excising an elliptical area of the nipple and areola like a "slice of pie," and these all healed primarily (P <0.001). CONCLUSIONS: Approximately half of the patients with subareolar abscess can be managed medically, but the other half will require definitive duct excision. A radial elliptical incision with primary closure results in excellent cosmesis and low long-term recurrence rates.
Authors: Ozan Barış Namdaroğlu; Hilmi Yazıcı; Ahmet Mücteba Öztürk; Savaş Yakan; Mehmet Yıldırım; Ahmet Deniz Uçar; Nazif Erkan Journal: J Breast Health Date: 2016-04-01