Mammary duct ectasia in children: report of a short series and review of the literature

Background: Mammary duct ectasia is uncommon in children, and is usually considered to be an acquired disease in adults. However the occurrence in infants and children suggest it may be developmental.

Aims: To report a case series of mammary duct ectasia, and review the published literature to ascertain the common findings and histological findings in children.

Study design: Case series report and review of the literature.

Results: We report three cases of mammary duct ectasia, an unusual disease in children. The most common presenting features are a bloody nipple discharge; there may also be a palpable mass or general breast enlargement. Two patients in this series presented with large masses simulating other conditions. Summary of all reported cases in children found that symptoms can arise from infancy, but is most common around the age of 3 years (range 2 months to 13 years), with a 5:2 male:female ratio. Histology centres on peri-ductal inflammation and dilation. Haemosiderin laden macrophages were seen commonly in this series; and may represent a histological marker in children. The disease is often self-limiting. Patients may require surgery for persistent nipple discharge or lump.

Conclusions: Duct ectasia should be entertained in small infants and children presenting with both small and large peri-areolar breast masses and/or bleeding. The occurrence of the disease in infants suggests that mammary duct ectasia may represent a developmental anomaly in the paediatric population.