A 36-year-old heavy smoker presents with her third episode of a painful periareolar abscess, and examination shows a fistulous opening at the edge of the areola. Which factor is most strongly implicated in this condition?
- A Current lactation
- B Cigarette smoking ✓
- C Oral contraceptive use
- D Family history of breast cancer
Correct answer: B. Cigarette smoking
Explanation
Periductal mastitis and its sequelae of periareolar abscess and mammary fistula occur predominantly in young smokers. Smoking is thought to injure the subareolar ducts directly, causing squamous metaplasia, duct blockage, and recurrent inflammation. Lactational abscess occurs during breastfeeding in a different age group, oral contraceptives have no established causal role, and family history of breast cancer is irrelevant to this benign inflammatory process.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.