Duct Excision

What is a duct excision?

A duct excision is an operation where milk ducts under the nipple and areola are removed.  It can be used to remove a single duct or all of the major ducts coming up to the nipple.

Why should I have a duct excision?

Most people have a duct excision because they are getting nipple discharge. Removing the duct/ducts that are causing the discharge treats the problem and can also give a diagnosis if a needle biopsy prior to the operation hasn’t been able to achieve this. Most of the time the cause of nipple discharge is benign but on occasion, invasive or pre-invasive cancer is found and may require further treatment.

How is the surgery performed?

You will have a general anaesthetic. If only one duct is discharging and this is able to be demonstrated, that duct has a wire passed down it. Your surgeon is then able to remove that duct only and leave the others intact.  This is called a microdochectomy. If there are multiple ducts discharging or the offending duct is not able to be localised, a total duct excision is performed.  In this case, all the major ducts are removed from under the nipple/areolar area. The incision for both of these procedures is around the areola. At the end of the operation, the incision is closed with dissolvable sutures and a waterproof dressing is placed.

What are the risks of duct excision?

Bleeding. Infection.  Recurrence of discharge.  Decreased sensation of the nipple/areola.  Rarely nipple/areolar necrosis.  Further procedure if something unexpected is found on the pathology results.

Before the operation

Do not squeeze the nipple in the period leading up to your operation date, it is helpful to have fluid present to be able to localise which duct is causing the problem. You cannot eat for at least 6 hours before your operation. You will be admitted on the day of the procedure.

After the operation

You will be able to go home the same day. You will need someone to drive you home. You should take regular simple pain relief at home. Leave the dressing on for 1 week at which stage it can be changed. You will be seen in the rooms in 3 weeks time for follow up and review of your results.

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