[The mammary duct fistula: a persistent problem that can be treated adequately]

Three female patients, 39, 39 and 46 years old, had recurrent, non-puerperal, subareolar abscesses caused by obstructed and dilated lactiferous ducts and resulting in paramamillary fistulas. Further recurrence was stopped by surgery. Based on the pathogenesis, surgery is the recommended treatment for this chronic ailment, i.e. fistulectomy using a radial incision through the centre of the nipple and excising the pathological nipple-areolar complex. Only the nipple is reconstructed, leaving the remainder of the wound open for healing by secondary intention and thus preventing recurrence.