A women noticed mass in her left breast with persistent bloody discharge. Histopathology revealed duct ectasia. More than one duct is involved. What is the treatment of choice?
**Core Concept**
Duct ectasia is a benign condition characterized by the dilatation of the lactiferous ducts in the breast, often associated with chronic inflammation and ductal cysts. The condition is often bilateral and may involve multiple ducts.
**Why the Correct Answer is Right**
The treatment of choice for duct ectasia, especially when multiple ducts are involved, is the surgical excision of the affected ducts. This approach provides definitive treatment by removing the source of the problem, thereby preventing potential complications such as recurrent bloody discharge or infection. The surgical excision may involve a simple duct excision or a more extensive procedure like a ductal excision with a biopsy.
**Why Each Wrong Option is Incorrect**
**Option A:** Mastectomy is not indicated for duct ectasia as it is a benign condition and not a malignant process. Mastectomy would be an overly aggressive approach.
**Option B:** Conservative management with antibiotics may be helpful in cases of associated infection but is not sufficient as the primary treatment for duct ectasia. It may also mask the underlying condition.
**Option C:** Ductography, while useful for diagnostic purposes, is not a treatment option for duct ectasia.
**Clinical Pearl / High-Yield Fact**
Duct ectasia is often associated with smoking and is more common in women who have had multiple pregnancies. These factors may contribute to the development of the condition.
**Correct Answer: C. Ductal excision with biopsy.**