Total duct excision through a linear radial areola incision
Association of Breast Surgery ePoster Library. Baker B. 05/15/17; 166312; P135
Mr. Benjamin Baker
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Abstract
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Excision of the major duct system of the breast was first described by Adair and Urban, and the operative technique was subsequently reported in detail by Hadfield in 1960. He described complete major duct excision through a skin incision following the lower half of the edge of the areola and reflection of the nipple-areola complex from the underlying breast tissue. This has the potential to result in nipple-areola complex necrosis, and loss of nipple sensation.
We describe a previously unreported linear radial incision within the areola for diagnostic complete major duct excision. This is orientated at the lower outer (5 o'clock left side, 7 o'clock right side) position, and extends from the base of the nipple to the areola border. Ducts can be accessed under direct vision at the medial end of the incision.
This technique does not require skin flaps to be raised or undermining of the nipple-areola complex, provides rapid access to the ducts, and ease of tissue approximation with a favourable cosmetic result. Because the incision is directly over the operative site, haemostasis is simpler and the operation can be performed under direct vision in good light. Furthermore, the orientation of the incision as described ensures that the scar is at an angle not easily visible to the patient because the nipple obscures their gaze. Nipple sensation is preserved.
This technique is utilised routinely at our institution without complication, and is reported with photographic illustration. Surgeons may wish to adopt this technique in their practice.
We describe a previously unreported linear radial incision within the areola for diagnostic complete major duct excision. This is orientated at the lower outer (5 o'clock left side, 7 o'clock right side) position, and extends from the base of the nipple to the areola border. Ducts can be accessed under direct vision at the medial end of the incision.
This technique does not require skin flaps to be raised or undermining of the nipple-areola complex, provides rapid access to the ducts, and ease of tissue approximation with a favourable cosmetic result. Because the incision is directly over the operative site, haemostasis is simpler and the operation can be performed under direct vision in good light. Furthermore, the orientation of the incision as described ensures that the scar is at an angle not easily visible to the patient because the nipple obscures their gaze. Nipple sensation is preserved.
This technique is utilised routinely at our institution without complication, and is reported with photographic illustration. Surgeons may wish to adopt this technique in their practice.
Excision of the major duct system of the breast was first described by Adair and Urban, and the operative technique was subsequently reported in detail by Hadfield in 1960. He described complete major duct excision through a skin incision following the lower half of the edge of the areola and reflection of the nipple-areola complex from the underlying breast tissue. This has the potential to result in nipple-areola complex necrosis, and loss of nipple sensation.
We describe a previously unreported linear radial incision within the areola for diagnostic complete major duct excision. This is orientated at the lower outer (5 o'clock left side, 7 o'clock right side) position, and extends from the base of the nipple to the areola border. Ducts can be accessed under direct vision at the medial end of the incision.
This technique does not require skin flaps to be raised or undermining of the nipple-areola complex, provides rapid access to the ducts, and ease of tissue approximation with a favourable cosmetic result. Because the incision is directly over the operative site, haemostasis is simpler and the operation can be performed under direct vision in good light. Furthermore, the orientation of the incision as described ensures that the scar is at an angle not easily visible to the patient because the nipple obscures their gaze. Nipple sensation is preserved.
This technique is utilised routinely at our institution without complication, and is reported with photographic illustration. Surgeons may wish to adopt this technique in their practice.
We describe a previously unreported linear radial incision within the areola for diagnostic complete major duct excision. This is orientated at the lower outer (5 o'clock left side, 7 o'clock right side) position, and extends from the base of the nipple to the areola border. Ducts can be accessed under direct vision at the medial end of the incision.
This technique does not require skin flaps to be raised or undermining of the nipple-areola complex, provides rapid access to the ducts, and ease of tissue approximation with a favourable cosmetic result. Because the incision is directly over the operative site, haemostasis is simpler and the operation can be performed under direct vision in good light. Furthermore, the orientation of the incision as described ensures that the scar is at an angle not easily visible to the patient because the nipple obscures their gaze. Nipple sensation is preserved.
This technique is utilised routinely at our institution without complication, and is reported with photographic illustration. Surgeons may wish to adopt this technique in their practice.
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