The Experts below are selected from a list of 228 Experts worldwide ranked by ideXlab platform
Margherita Serra - One of the best experts on this subject based on the ideXlab platform.
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Recurrent Periductal Mastitis: Surgical treatment.
Surgery, 2016Co-Authors: Mario Taffurelli, A. Pellegrini, Donatella Santini, Simone Zanotti, Domenico Di Simone, Margherita SerraAbstract:Background Recurrent Periductal Mastitis is a benign breast disorder that often features a mammary fistula that runs between periareolar skin and the ductal mammary system. Due to the high recurrence rate of this disease, its management is controversial. This study was designed to assess the efficacy of fistulectomy (Hadfield operation), particularly with regard to its long-term outcome. Methods We reviewed all women with recurrent Periductal Mastitis who underwent the Hadfield operation in the Breast Center in S.Orsola-Malpighi Hospital (Bologna University) from 2005 to 2015. All but one of the patients were heavy smokers and presented with a recurrent periareolar abscess and a periareolar mammary fistula. Results Eighteen women underwent the Hadfield surgical treatment. Mean age at the time of presentation was 42 years; 17 of 18 women smoked >10 cigarettes/d. All patients had a breast ultrasonography or mammography. Half of the patients had undergone antibiotic therapy with one or more prior abscess drainages or another form of operative treatment. All patients who underwent operative treatment had no postoperative events and were satisfied with the cosmetic results. Squamous metaplasia was always present in the specimens. After a median follow-up of 36 months, 2 patients developed a recurrence after a few months; neither had stopped smoking. Conclusion Based on our review of the literature and taking into account the results of this study, it seems clear that the best treatment involves a combined total excision of the affected duct and the fistulous tract. Due to the important role of smoking in this disease, it is important to encourage patients to stop smoking.
R.e. Mansel - One of the best experts on this subject based on the ideXlab platform.
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Recent developments in the study of benign breast disease : the proceedings of the 5th International Symposium on Benign Breast Disease, London, May 1993
1994Co-Authors: Gynaecologists, R.e. ManselAbstract:This volume is a record of the proceedings of the Fifth International Benign Breast Disease Symposium, which provides a comprehensive review of the clinical management of benign breast diseases, and reviews some of the relevant research areas. The general themes covered are breast pain, cysts and Periductal Mastitis and epidemiology, with new work being presented in all these areas. The theme of "guidelines for referral for GPs" is also discussed.
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Periductal Mastitis in adolescent girls
The Breast, 1993Co-Authors: C.a. Gateley, R.e. ManselAbstract:The pathogenesis of the duct ectasia/Periductal Mastitis complex remains unclear.’ The classic theory states that duct dilatation (ectasia) is the primary event and that stagnant secretion leaks from the dilated ducts producing a chemical inflammation, which presents as Periductal Mastitis. Duct dilatation occurs during breast involution which begins around the age of 35, which conforms to the age distribution of duct dilatation seen in postmortem studies’ and of clinically presenting duct ectasia.3 However, the clinical manifestations of Periductal Mastitis, subareolar abscess and mammary duct fistula are more frequently seen in women under the age of 35. This has led to the suggestion that the classical sequence of events may be incorrect and that Periductal Mastitis may be a separate condition. The aetiology of Periductal Mastitis in these young women is unknown, although two recent studies suggest that cigarette smoking may be important4,’ A further study” has shown a propensity for smokers to develop heavy oral colonisation of the same range of bacteria which can be cultured from the lesions of Periductal Mastitis.’ The clinical details are presented in the Table. None of the patients had any past or family history of breast disease. One patient was taking the oral contraceptive pill, she was 20 months postpartum and had not breast fed, the other 5 patients were nulliparous. Case 6 was referred with a subareolar mass and nipple discharge which spontaneously resolved, unilateral transverse nipple retraction was noted and a diagnosis of Periductal Mastitis made. She represented 7 months later with a subareolar abscess and a mammary duct fistula on the same side. None of the other patients have developed further breast problems. Nipple retraction was present in the three patients who required surgical treatment (cases 2, 5 and 6), and was bilateral in case 2. Staphylococcus epidermidis and Bacteroides species were cultured from cases 2 and 5 respectively; case 6 had received prior antibiotic treatment and the abscess was sterile. All these patients were regularly exposed to tobacco smoke. Two smoked themselves and the others were passive smokers as members of their household smoked. The two active smokers developed the most aggressive
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Psychiatric illness in patients with severe treatment-resistant mastalgia
General hospital psychiatry, 1993Co-Authors: Peter L. Jenkins, N. Jamil, C. Gateley, R.e. ManselAbstract:Mastalgia, or breast pain, is one of the most common symptoms in patients seeking consultation in a breast clinic and is also a frequent reason for general practice consultation. Breast pain is present in approximately 66% of screened populations and approximately 50% of all patients at breast clinics. Between 5% and 24% of patients with operable breast cancer present with breast pain, which is commonly unilateral, constant in position and persistent. However, in patients with mastalgia in which the possibility of cancer has been excluded with appropriate investigations, subsequent neoplasia is rare at about 0.5% [l]. A number of clinically defined syndromes of mastalgia have been described and the most common are cyclical pronounced mastalgia (related to the menstrual cycle and notable for intensity and/ or duration), present in 40%; and noncyclical mastalgia, often associated with duct ectasia or Periductal Mastitis (in which pain occurs consistently in the same place with no temporal pattern present) PI* Following extensive study of this patient population, a detailed management protocol has been described and is used in the Cardiff Breast Clinic (Table 1). After investigation to exclude cancer, the patient is reassured and the pain is then defined
N. Florea - One of the best experts on this subject based on the ideXlab platform.
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91 P - Periductal Mastitis and mammary duct ectasia - two stages of the same disease?
European Journal of Cancer, 1996Co-Authors: C. Diaconu, D. Socolov, C. Dragomir, G. Costachescu, N. FloreaAbstract:This paper deals with a disease known under several names: obliterative Mastitis, plasma cell Mastitis, Periductal Mastitis, comedoMastitis, mammary duct ectasia, which seem to define different stages of the same illness. Out of 67 cases of benign breast diseases recorded in our hospital during a 3-year interval, 15 cases were diagnosed as Periductal Mastitis or mammary duct ectasia. The dominant pathological findings in younger patients (17–40 years) were Periductal infiltration with plasma cells, lymphocytes or polymorphic cells, while in older patients (over 52) duct ectasia and nipple retraction were prevalent, being frequently associated with Periductal infiltration. Microbiological examination of the intraoperative samples showed different germs in most cases. Thus antibiotic prophylaxis was justifted in our cases. Our study supports the idea that this disease begins with a silent ductal infection with Periductal infiltration, and ends with chronic inflammation and fibrosis with consequent duct ectasia. Therefore, Periductal Mastitis, non-puerperal Mastitis and duct ectasia arc stages of the same pathological process. Due to the clinical similarity with breast cancer, treatment by sectorectomy becomes mandatory.
J.m. Dixon - One of the best experts on this subject based on the ideXlab platform.
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Periductal Mastitis and duct ectasia: an update
The Breast, 1998Co-Authors: J.m. DixonAbstract:Abstract Periductal Mastitis and duct ectasia appear to have different clinical syndromes: they affect different age groups and they appear to have different aetiologies. Smoking and bacteria, particularly anaerobic bacteria, have an aetiological role in Periductal Mastitis whereas duct ectasia appears to be an involutionary phenomenon, with clinically significant duct ectasia being considered an aberration of normal involution. There is no evidence that Periductal Mastitis precedes duct ectasia. Periductal Mastitis and duct ectasia should therefore be considered as two separate conditions.
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Periductal Mastitis and duct ectasia: different conditions with different aetiologies.
The British journal of surgery, 1996Co-Authors: J.m. Dixon, O. Ravisekar, Udi Chetty, Thomas J. AndersonAbstract:A prospective study of 14,225 patients has been undertaken to determine the inter-relationship between Periductal Mastitis and duct ectasia and to establish whether there is an association between smoking and either of these two conditions. Periductal Mastitis affected women at a younger age than did duct ectasia. Of 139 patients with the clinical syndrome of Periductal Mastitis, 97 (70 per cent) had a past history of previous Periductal Mastitis, compared with only one (1 per cent) of 186 patients with the clinical syndrome of duct ectasia (P < 0.0001). There was a significant excess of smokers in patients with clinically (124 (89 per cent) of 139) and pathologically (71 (91 per cent) of 78) diagnosed Periductal Mastitis compared with age-matched controls (both P < 0.001), but there was no such excess in those with clinically (52 (28 per cent) of 186) or pathologically (15 (23 per cent) of 64) diagnosed duct ectasia. These data suggest that Periductal Mastitis and duct ectasia are separate conditions which affect different age groups, have different aetiologies, and should now be considered as separate entities.
Mario Taffurelli - One of the best experts on this subject based on the ideXlab platform.
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Recurrent Periductal Mastitis: Surgical treatment.
Surgery, 2016Co-Authors: Mario Taffurelli, A. Pellegrini, Donatella Santini, Simone Zanotti, Domenico Di Simone, Margherita SerraAbstract:Background Recurrent Periductal Mastitis is a benign breast disorder that often features a mammary fistula that runs between periareolar skin and the ductal mammary system. Due to the high recurrence rate of this disease, its management is controversial. This study was designed to assess the efficacy of fistulectomy (Hadfield operation), particularly with regard to its long-term outcome. Methods We reviewed all women with recurrent Periductal Mastitis who underwent the Hadfield operation in the Breast Center in S.Orsola-Malpighi Hospital (Bologna University) from 2005 to 2015. All but one of the patients were heavy smokers and presented with a recurrent periareolar abscess and a periareolar mammary fistula. Results Eighteen women underwent the Hadfield surgical treatment. Mean age at the time of presentation was 42 years; 17 of 18 women smoked >10 cigarettes/d. All patients had a breast ultrasonography or mammography. Half of the patients had undergone antibiotic therapy with one or more prior abscess drainages or another form of operative treatment. All patients who underwent operative treatment had no postoperative events and were satisfied with the cosmetic results. Squamous metaplasia was always present in the specimens. After a median follow-up of 36 months, 2 patients developed a recurrence after a few months; neither had stopped smoking. Conclusion Based on our review of the literature and taking into account the results of this study, it seems clear that the best treatment involves a combined total excision of the affected duct and the fistulous tract. Due to the important role of smoking in this disease, it is important to encourage patients to stop smoking.