I have had 6 surgeries on my left breast to remove and drain the same abcess directly under my left nipple. I am in pain once again and I do not want to go through this surgery again only to be going through the same thing 6 months down the road. Is there any surgeon who would do a complete mastectomy and reconstruct my breast? Is that possible?
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Doctor Answers 2
Recurrent Subareolar Abscess
Hello, I understand and hope you can solve this matter soon. To be honest I do not think a complete mastectomy is the right procedure. We can not give a 100% accurate diagnosis, nevertheless from your message, it seems to be a breast ductile block (glandular ducts) possible caused by some kind of metaplasia of the squamous cells, and in order to be solve the full duct (or ducts) need to be surgically excised (removed) and the tissue being analyzed by a Pathologist MD. Share your concern w/your PS and if necessary look for a second opinion.
Recurrent breast abscess treatment
I am sorry to hear that you are dealing with this frustrating problem. I have had a few ladies in my office this year in tears over this same issue. The disease is called recurrent subareolar abscess. It is due to squamous metaplasia (cells that replicate and block things up) of a milk duct (or ducts) in your breasts. Simple drainage procedures are inadequate. A surgeon must locate the blocked duct and excise it along with the prior abscess cavity/associated scarring. If this does not happen, your risk of further abscesses is higher than 75% throughout your life. I would not yet rush into a mastectomy. The surgery I am proposing is very much like a lumpectomy for breast cancer and it has a decent success rate. Depending on the size of the area being removed, it may leave you with an aesthetic looking breast. But, you would need to consult with a breast surgeon to get a better idea. Plastic surgeons can be involved at some point if there is a symmetry issue after the duct is removed. You first need a breast surgeon who specializes in breast cancer. I will leave a link for the folks at UT Southwestern. Before you have that consult, make sure you have an updated mammogram done. And, this disorder is frequently linked to smoking so, try to stop with the help of a primary care doctor if you currently smoke. I hope this information helps!
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