Recurrent periductal mastitis: Surgical treatment

Clinical characteristics, classification and surgical treatment of periductal mastitis

“…For type IIb patients, abscess drainage is recommended before mass excision and flap repair is needed when the tissue defect is too large to suture up directly. For type III PDM, fistulectomy (11,(30)(31)(32)(33) is deemed to be effective with favorable cosmetic result. For type IV PDM, fistulectomy and wide excision are both necessary.…”

“…Clinically, PDM can present with nipple discharge, nipple retraction, a subareolar breast mass with or without pain, a periareolar abscess, or a mammary fistula (i.e., communication between a major subareolar duct and the skin). The subcutaneous abscess in the region of the areola usually discharges spontaneously, and then appears to resolve only to recur again (11). Empiric antibiotic therapy and wide surgical excision are the main treatments for PDM.…”

Mastitis periductal y absceso subareolar de la mama

“…Algunos autores recomiendan la intervención quirúrgica temprana con escisión del absceso, de la vía fistulosa y de la porción terminal del conducto subareolar, debido a la alta tasa de recurrencia con antibióticoterapia exclusiva (29,30) . Otros consideran que el manejo médico, que incluye la antibióticoterapia y el drenaje son suficientes y que la cirugía se reservará para casos en los que el manejo médico falla (7,22) .…”

ABM Clinical Protocol #30: Breast Masses, Breast Complaints, and Diagnostic Breast Imaging in the Lactating Woman

“…Patients experience chronic, persistent abscesses, and fistulae in the superficial periareolar region. Optimal treatment is controversial and may include smoking cessation, antibiotic therapy, and/or drainage, with surgical excision reserved for refractory cases 19 (IV). Idiopathic granulomatous mastitis is an inflammatory disorder of the breast with unclear etiology that results in erythema, abscess, and fistula formation.…”