Breast Duct Surgery

(Microdochectomy)

Some patients with a nipple discharge may require excision of the involved duct, depending on the characteristics of the discharge. Excision of the involved milk duct is called a microdochectomy. This can be performed as a day case procedure under a general anaesthetic. The involved duct is identified on the surface of the nipple by applying pressure to the surrounding tissue. A small probe is then inserted into the duct to mark its course in the breast. An incision around the edge of the areola is made (circum-areolar incision). The tissue around the probe is excised for several centimetres beyond the nipple/areola complex. The tissue is usually excised up to the under-surface of the nipple, as often the cause of the discharge will be within a couple of centimetres of the nipple. Dissolvable sutures are used in the skin and it is recommended an adhesive tape or silicone dressing is applied regularly for six weeks to improve cosmesis. Surgery may result in some alteration of the nipple sensation which usually would be a temporary effect. There may be some minor change in contour of the nipple/areola region as a result of the biopsy.