Recurrent periductal mastitis: Surgical treatment

Area of Science:

• Breast Surgery
• Surgical Oncology
• Benign Breast Disease

Background:

• Recurrent periductal mastitis is a benign breast disorder characterized by mammary fistulas.
• High recurrence rates make management controversial.
• The Hadfield operation (fistulectomy) is evaluated for long-term efficacy.

Purpose of the Study:

• To assess the efficacy of the Hadfield operation for recurrent periductal mastitis.
• To evaluate the long-term outcomes of fistulectomy.
• To identify factors influencing disease recurrence.

Main Methods:

• Retrospective review of 18 women with recurrent periductal mastitis treated with the Hadfield operation (2005-2015).
• Analysis of patient demographics, smoking habits, prior treatments, and surgical outcomes.
• Median follow-up of 36 months.

Main Results:

• 17 of 18 patients were heavy smokers; all presented with recurrent periareolar abscess and fistula.
• All patients were satisfied with cosmetic results and had no postoperative events.
• Two patients (11%) experienced recurrence within months; neither had quit smoking.

Conclusions:

• Combined total excision of the affected duct and fistulous tract is the optimal treatment.
• Smoking cessation is critical for managing recurrent periductal mastitis.
• The Hadfield operation offers good cosmetic outcomes and low recurrence rates when combined with smoking cessation advice.