A 49-year-old non-smoking multiparous woman reports recurrent thick, greenish-brown nipple discharge from multiple ducts with a tender subareolar mass. Mammogram shows dilated retroareolar ducts containing secretions and coarse calcification. Biopsy shows marked periductal inflammation rich in plasma cells with ductal dilation and fibrosis. What is the most likely diagnosis?

• A Duct papillomatosis
• B Periductal mastitis
• C Fat necrosis
• D Mammary duct ectasia ✓

Explanation

Duct ectasia affects perimenopausal multiparous women, presents with thick multicoloured discharge from multiple ducts and a subareolar mass, and shows dilated ducts with periductal plasma cells. The distractor periductal mastitis occurs predominantly in young smokers, involves smaller terminal ducts, and more often produces a periareolar abscess or mamillary fistula rather than this chronic insidious picture.

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.