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Twenty-two year experience with recurring subareolar abscess andlactiferous duct fistula treated by a single breast
1Department of Surgery, Yale University School of Medicine, P.O. Box 208062, New Haven, CT 06520, USA. donald.lannin@yale.edu
Background:
Recurring subareolar abscess and lactiferous duct fistula are frequently difficult to manage.
Methods:
Personal experience with 67 cases treated during the past 22 years is reviewed.
Results:
There were 38 cases of subareolar abscess and 29 of lactiferous duct fistula. Thirty-three patients had resolution with antibiotics and needle aspiration or with incision and drainage,but 34 patients required definitive duct excision. Eight patients had duct excision through circumareolar incisions, and 5 of these had prolonged healing problems or recurrence within 1 year. Twenty-six patients had duct excision by placing a probe into the duct and radially excising an elliptical area of the nipple and areola like a "slice of pie," and these all healed primarily (P <0.001).
Conclusions:
Approximately half of the patients with subareolar abscess can be managed medically, but the other half will require definitive duct excision. A radial elliptical incision with primary closure results in excellent cosmesis and low long-term recurrence rates.
