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HealthInfo Canterbury

Duct excision

breast anatomyOn average, women have 12 to 15 ducts in each breast, which carry milk from the milk glands to the nipple.

If a duct is diseased, it will be removed in an operation called a duct excision.

The most common reason for this is intraductal papilloma, which is a non-cancerous, wart-like growth in a duct that can cause a bloody discharge. It's also sometimes called ductal papilloma or papilloma of the breast.

If you have an intraductal papilloma, your GP will refer you to a breast specialist to decide what type of treatment you need. The breast specialist decides this after a breast multidisciplinary meeting at Christchurch Hospital. The breast multidisciplinary meeting includes a surgeon, radiologist, oncologist and pathologist.

Depending on where the papilloma is, a radiologist can sometimes remove it using special needles guided by ultrasound.

Surgery can remove a single duct (this is called a microdochectomy, my-kro-do-kek-to-me). Or it can remove all the ducts behind the nipple (this is called a total duct excision). It you're younger, you'll usually be offered a microdochectomy. This minimises issues with breastfeeding in the future.

Risks and possible complications

Scarring

Talk to your surgeon about how they'll operate and what scars you'll have afterwards. At first the scars will be narrow red lines, but they'll probably become paler over six months to a year. A few people get raised, red, and thickened scars (called keloid or hypertrophic). Tell your surgeon if you've had this type of scar before.

Nipple changes

Some women lose sensation in their nipple, and the shape of their nipple can change.

Very rarely, you can lose the nipple. This happens in less than 1% of cases and is more likely in women who smoke. You should give up smoking for at least three months before surgery to minimise the risk.

General surgical risks

All surgery and anaesthetics have some risks. See General surgical risks and Having an anaesthetic.

You'll be invited to attend a pre-admission clinic before your surgery. You can discuss any concerns then.

Written by HealthInfo clinical advisers. Endorsed by oncoplastic breast and general surgeon, Canterbury DHB. Page created December 2018.

Sources

See also:

Overview of surgery

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Review key: HIBRS-86141