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Although mammary duct ectasia often doesn't cause signs and symptoms, you may experience:

• A dirty white, greenish or black nipple discharge
• Discharge from one or both nipples
• Tenderness in the nipple or surrounding breast tissue
• Redness
• A lump or thickening
• An inverted nipple

A bacterial infection called mastitis also may develop in the affected milk duct and cause inflammation in the area around the nipple (areola) and fever. Signs and symptoms of mammary duct ectasia usually improve on their own.

When to see a doctor
Although mammary duct ectasia is not a sign of breast cancer, it's important for your doctor to promptly evaluate any changes in your breasts. If you have symptoms of mammary duct ectasia — especially unusual nipple discharge — make an appointment with your doctor for an evaluation. Your doctor will ask you some questions and perform a physical exam.

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Your breasts are made up of connective tissues that include a system of milk ducts — tiny passages that carry milk to the nipples. Mammary duct ectasia occurs when a milk duct beneath the nipple becomes dilated and inflamed.

Experts don't know exactly what causes mammary duct ectasia. Some speculate the cause to be associated with:

• Breast tissue changes due to aging. As you age, the composition of your breast tissue changes from mostly glandular to mostly fatty in a process called involution. These normal breast changes can sometimes lead to blockage of a milk duct and the inflammation associated with mammary duct ectasia.
• Smoking. Cigarette smoking may be associated with dilation of milk ducts, which can lead to inflammation and, possibly, mammary duct ectasia. The effect of cigarette smoking on breast tissue seems to be greater in younger women.
• Nipple inversion. A newly inverted nipple may obstruct milk ducts, causing inflammation and infection. A nipple that's newly inverted also could be a sign of a more serious underlying condition, such as cancer.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Complications of mammary duct ectasia are usually minor and often more bothersome than serious. These may include:

• Nipple discharge. Nipple discharge caused by mammary duct ectasia can be frustrating. Fluid leaking from your nipples can cause embarrassing wetness and staining on your clothes.
• Breast discomfort. Mammary duct ectasia can cause redness, swelling and tenderness around your nipples.
• Infection. A bacterial infection such as mastitis may develop in the affected milk duct, sometimes causing you to have pain in or around your nipple or to feel ill and have a fever. Untreated infection could lead to an abscess — a collection of pus in your breast tissue — that may require surgical drainage.
• Concern about breast cancer. When you notice a change in your breast, you may immediately start to worry that it's a sign of breast cancer. That fear can be particularly hard to shake if you develop a hard lump around a milk duct affected by mammary duct ectasia. It's important to remember that mammary duct ectasia is not associated with an increased risk of breast cancer.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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For evaluation of a new breast lump or changes in your breast exam, you're likely to start by seeing your primary health care provider. In some cases, based on a clinical breast examination or findings on an imaging test, you may be referred to a breast health specialist.

What you can do
The initial evaluation focuses on your medical history. You'll discuss with your doctor the symptoms you're experiencing, their relation to your menstrual cycle and any other relevant information. To facilitate this discussion:

• Take note of all your symptoms, even if they seem unrelated to the reason for which you scheduled the appointment.
• Review key personal information, including major stresses or recent life changes.
• Make a list of all medications, vitamins and supplements that you regularly take.
• Write down questions to ask your doctor. List your questions from most important to least important, in case time runs out.

What to expect from your doctor
Your doctor may ask you questions about:

• How long you've experienced symptoms
• If you've noticed a change in symptoms over time
• Whether you experience any breast pain and, if so, the severity of your pain
• If you have any nipple discharge and, if so, its color, consistency and amount
• Whether symptoms occur in one or both breasts
• If you have any other signs or symptoms, such as fever
• When you had your last mammogram
• Your family history
• Your personal history of precancerous breast lesions
• If you've previously had a breast lump or breast biopsy

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Based on information you provide to your doctor and the results of a physical exam, you might need to have additional tests, which may include:

• Diagnostic ultrasound of the nipple and areola. An ultrasound uses sound waves to make images of breast tissue. It allows your doctor to evaluate the milk ducts beneath your nipple. A diagnostic ultrasound allows your doctor to zero in on an area of suspicion.
• Diagnostic mammography. Mammography provides X-ray images of your breast and can help your doctor evaluate your breast tissue. A diagnostic mammogram provides more detailed views of a specific area of your breast than does a screening mammogram.

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Mammary duct ectasia often improves without treatment. If your symptoms are bothersome, however, treatment options may include:

• Antibiotics. Your doctor may prescribe a 10- to 14-day course of antibiotics to treat any infection caused by mammary duct ectasia. Even if your symptoms greatly improve or disappear altogether, it's important to take the entire course of medication. While waiting for the antibiotics to take effect, take a mild pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others), as needed for breast discomfort.
• Surgery. If antibiotics and self-care methods don't work, the affected milk duct may be surgically removed. This procedure is done through a tiny incision at the edge of the colored tissue around your nipple (areola). However, surgery rarely is needed for mammary duct ectasia.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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To relieve discomfort associated with mammary duct ectasia, you might try these self-care measures:

• Apply warm compresses. A warm compress applied to your nipple area can reduce the pain and swelling often caused by mammary duct ectasia.
• Wear a bra pad. If you have nipple discharge, wear a bra pad or nursing pad to keep the fluid from leaking through your clothing. These pads are available at drugstores and at most retail stores with a large selection of baby-care products.
• Wear a support bra. Wear a bra with good support to keep your breasts more secure and help reduce breast discomfort. Also, a support bra can help keep bra pads in place if you have nipple discharge.
• Sleep on the opposite side. Try not to sleep on the side of your affected breast. This helps to prevent further discomfort and to keep any swelling down.
• Stop smoking. Smoking may make it harder to treat an infection, and ongoing smoking may result in recurrent infections or an abscess.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.