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Duct excision

Tangohanga pū

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 watery or bloody discharge. It's also sometimes called ductal papilloma or papilloma of the breast.

If you have an intraductal papilloma, your general practice team will refer you to a breast specialist to decide what type of treatment you need. They will usually recommend having the duct removed because there is a small chance the growth can develop into cancer.

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 or central 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 will operate and what scars you'll have afterwards. At first the scars will be narrow red lines, but they will 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. Last reviewed September 2022.

Sources

See also:

Overview of surgery

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