Mammary Duct Ectasia
Mammary duct ectasia (ek-TAY-zhuh) is a noncancerous breast condition that affects the tubes that carry milk, called the milk ducts. It happens when one or more milk ducts beneath your nipple widen, thicken and fill with fluid. This can cause the milk ducts to become blocked or clogged with a thick, sticky substance that often is yellow or green in color.
Mammary duct ectasia often has no symptoms. But some people may have:
- Nipple discharge.
- Breast tenderness.
- Inflammation of the clogged duct, which is called periductal mastitis.
Mammary duct ectasia most often happens during perimenopause, around age 45 to 55. But it also can happen after menopause. The condition often gets better without treatment. If symptoms don’t go away, you may need antibiotics or possibly surgery to remove the clogged milk duct.
Although changes in your breasts may seem concerning, mammary duct ectasia and periductal mastitis aren’t risk factors for breast cancer. It’s a good idea to talk with your healthcare professional about any changes in your breasts.
Mammary duct ectasia often doesn’t cause any symptoms. People with symptoms may have:
- A dirty white, yellow, green or black nipple discharge from one or both nipples.
- Tender breasts or nipples.
- A change in color of the nipple and surrounding skin, called the areola. This change may be a shade of red, purple or brown, depending on your skin color.
- A breast lump or thickness near the clogged duct.
- A nipple that’s turned inward, also called inverted.
Sometimes, a blocked milk duct gets infected. This is called mastitis. Mastitis can cause breast tenderness, inflammation in the areola and fever.
Symptoms of mammary duct ectasia may get better on their own.
When to see a doctor
Make an appointment with your healthcare professional if you notice changes in your breasts that don’t go away or that worry you. Some things to watch for are a new breast lump, sudden nipple discharge, a change in skin color, skin swelling or irritation, or an inverted nipple.
Experts don’t know exactly what causes mammary duct ectasia. The condition may be related to changes in the breast tissue. Your breasts are made up of connective tissues that have tiny tubes inside called milk ducts that carry milk to your nipple. Mammary duct ectasia happens when a milk duct beneath the nipple widens, which often happens with age. The duct walls may thicken and fill with fluid, becoming blocked or clogged with a sticky substance. This can cause painful swelling, called inflammation.
Usually, the complications of mammary duct ectasia aren’t serious, but they can be bothersome. They may include:
- Nipple discharge. Nipple discharge caused by mammary duct ectasia can be frustrating. Fluid leaking from your nipples can cause embarrassing wetness and stains on your clothes.
- Breast pain. Mammary duct ectasia can cause swelling and tenderness around your nipples.
- Infection. An infection may develop in the clogged milk duct. This can cause pain in or around the nipple, a sick feeling, or a fever. Lasting skin color changes and pain that’s getting worse could be symptoms of a bacterial infection. A bacterial infection may lead to a collection of pus in your breast tissue. This is called an abscess. A procedure may be needed to drain the abscess.
- Concern about breast cancer. When you notice a change in your breast, you may worry that it’s a sign of breast cancer. This may be especially true if you have a hard lump around the nipple or areola. Having mammary duct ectasia doesn’t increase your risk of breast cancer. Still, it’s important to see your healthcare professional soon anytime you notice breast changes.
Mammary duct ectasia may be diagnosed based on information you give to your healthcare professional and the results of a physical exam. You also might need additional tests, such as:
- Ultrasound of the nipple and areola. An ultrasound uses sound waves to make images of breast tissue. It allows your healthcare professional to look at the milk ducts beneath your nipple.
- Mammogram. A mammogram is an X-ray of your breast. It can help your healthcare professional look at your breast tissue. If a closer look is needed, your healthcare professional may use a diagnostic mammogram. This gives more-detailed views of a specific area of your breast than a screening mammogram does.
- Magnetic resonance imaging, also called MRI. MRI uses a magnetic field and radio waves to create pictures of the inside of the breast. This imaging may be used if other tests don’t give your healthcare professional enough information.
- Biopsy. If you have a lump in your breast, your healthcare professional may recommend a biopsy. A biopsy is a procedure to remove a sample of tissue for testing in a lab. This is done by inserting a needle through the skin and into the breast tissue. The tissue is sent to a lab and looked at under a microscope. This test can tell if the cells from the sample are cancerous.
Mammary duct ectasia doesn’t always require treatment. But if you have symptoms that bother you, treatment options may include:
- Antibiotics. Your healthcare professional may prescribe an antibiotic for 10 to 14 days to treat an infection caused by mammary duct ectasia. Even if your symptoms get better or go away after starting the antibiotic, it’s important to take all your medicine as prescribed.
- Pain medicine. You could try a mild pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others), as needed for breast pain. Follow your healthcare professional’s recommendation on which pain reliever is best for you.
- Surgery. If an abscess forms and antibiotics don’t work, surgery might be needed to remove the clogged milk duct. This is done through a tiny cut made near the nipple. Surgery is usually not needed for mammary duct ectasia.
References
- Banikarim C, et al., eds. Breast masses in children and adolescents. https://www.uptodate.com/contents/search. Accessed Feb. 18, 2025.
- Duct ectasia. American Cancer Society. https://www.cancer.org/cancer/breast-cancer/non-cancerous-breast-conditions/duct-ectasia.html. Accessed Feb. 4, 2025.
- Nipple discharge. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/nipple-discharge. Accessed Feb. 4, 2025.
- Dabbs DJ. Reactive and inflammatory conditions of the breast. In: Breast Pathology. 3rd ed. Elsevier; 2024. https://www.clinicalkey.com. Accessed Feb. 4, 2025.
- Wood JR. Mammary duct ectasia: Symptomatology, diagnosis, and treatment. Radiologic Technology. 2021;92:383M.
- Pruthi S (expert opinion). Mayo Clinic. Feb. 27, 2025.
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