Recurrent subareolar abscess of the breast and squamous metaplasia of the lactiferous ducts: a clinical syndrome.

When squamous metaplasia of the lactiferous ducts occurs, the normal cuboidal epithelium lining the lactiferous ducts is replaced by squamous epithelium, leading to intraluminal accumulation of epithelial debris. Recurrent subareolar abscess is a common co-feature of the disease. The chronicity of suppuration is related to a general unfamiliarity with this entity and its underlying pathogenesis and failure to recognize the inadequacy of simple incision and drainage. Recent experience with six patients with recurrent subareolar abscess suggests that cure requires excision of the disease duct(s) and abscess cavity in continuity with the nipple inversion, which also is seen with this problem. The clinical triad of recurrent subareolar abscess, intermittent periareolar drainage, and (possibly) nipple inversion should alert the practitioner to this entity. Appropriate initial operative management will minimize recurrence.