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Lactiferous fistula

M E Passaro¹, T A Broughan, B A Sebek

¹Department of Surgery, Cleveland Clinic Foundation, Ohio.

Journal of the American College of Surgeons

|January 1, 1994

Summary

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Zuska's disease, a rare lactiferous fistula, causes recurrent nipple abscesses. Definitive treatment involves core excision of the fistula and surrounding breast tissue for lasting relief.

Area of Science:

Breast Surgery
Pathology
Dermatology

Background:

Lactiferous fistula, or Zuska's disease, is a rare, recurrent condition involving draining abscesses around the nipple.
It is often misdiagnosed and inadequately treated due to limited understanding.

Purpose of the Study:

To review clinical features and treatment outcomes for lactiferous fistula.
To identify definitive surgical therapy for this condition.

Main Methods:

Retrospective review of 51 women diagnosed with lactiferous fistula between 1961 and 1991.
Histologic examination of surgical specimens by a breast pathologist.
Comparison of surgical techniques and outcomes.

Main Results:

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Patients ranged from 14 to 66 years (mean 40). Common symptoms included areolar swelling, draining fistula, nipple discharge, and pain.
Histology revealed keratinizing squamous epithelium replacing lactiferous duct lining in all cases.
Core excision of the fistula and retroareolar/nipple ductal tissue was definitive in 47/48 patients.

Conclusions:

Lactiferous fistula is characterized by squamous metaplasia of lactiferous ducts.
Core excision of the affected ductal and fibroglandular tissue offers definitive treatment for Zuska's disease.