Noncosmetic operations for benign breast disease

The operation of excision of the major duct system of the breast has remained unchanged since it was first designed by Adair and described by Hadfield, Urban, and recently by Preece from Professor Hughes' unit in Cardiff. Operations for diseases for a single major duct or the whole major duct system, namely subareolar excision of the major ducts of the breast, are discussed. Technical problems are discussed and suggestions are made on ways to avoid these problems. An adequately performed operation should render the patient free from her disease with a good cosmetic result. Operations for excision of palpable and radiologically detected lesions are described. Since a histological examination is the final arbiter; methods ensuring that the whole lesion is demonstrated, excised, and fully examined are discussed. The medico-legal aspect of this is of obvious importance.