Arif Hakan Demirel, Atilla Cengiz, Erkut Bayram.
The excision of fistula and single major duct in the treatment of chronic subareolar mastitis.
Pak J Surg Jan ;26(2):134-7.

Objective: The aim of the present study was to evaluate treatment results in patients with chronic subareolar mastitis characterized by episodes of mastitis, abscess formation, a subareolar mass, chronic fi stulae, and retraction of the nipple. Design: Retrospective study Setting&Duration: The patients were evaluated between May 2005 and January 2009 in Ankara Training and Research Hospital, Ankara . Methodology: Ten patients (mean age, 43.9 years) with subareolar mastitis were included in the study. Breast ultrasonography was performed pre-operatively on all patients, and culture material of the aff ected tissue was obtained by fi ne needle aspiration biopsy. Oral ciprofl oxacine treatment (500 mg twice daily) was administered for 7 days pre-operatively and 7 days post-operatively. Excision of the the fistula tract and single major duct excision technique was performed on six patients under general anesthesia, and on four patients under local anesthesia. The patients were followed for a mean period of 16.5 months. Results: The most common complaint was discharge from a localized breast skin fistula (60%) and mastalgia (50%). Fistula openings were found adjacent to the aereola in eight patients. Culture growth was identified in 9 of 10 patients. Staphylococcus epidermidis culture growth was observed in seven patients, Peptostreptococcus culture growth in two patients, and a culture growth of both microorganisms in two patients. Histopathologic diagnosis were reported as periductal mastitis. No recurrences were identified in any of the patients. Conclusion: Excision of the the fistula tract and single major duct excision procedure appears to be a suitable method in the treatment of chronic subareolar mastitis, with a low recurrence rate and satisfactory cosmetic results.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com