A 51-year-old multiparous woman presents with a 3-month history of a tender subareolar lump with slit-like nipple retraction and copious greenish-brown multiduct discharge. Mammogram shows dilated retroareolar ducts with no suspicious calcification. What is the most likely diagnosis?
- A Mammary duct ectasia ✓
- B Intraductal papilloma
- C Periductal mastitis with recurrent abscess
- D DCIS presenting with nipple retraction
Correct answer: A. Mammary duct ectasia
Explanation
Mammary duct ectasia occurs in perimenopausal and postmenopausal women, classically causing a subareolar mass, slit-like nipple inversion, and thick green or brown multiduct discharge from dilated ducts containing inspissated secretions. Intraductal papilloma causes unilateral single-duct blood-stained discharge, and periductal mastitis affects younger smokers with periareolar inflammation. The age, multiduct coloured discharge, and dilated ducts on imaging make duct ectasia the answer.
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.