An Alternative Approach to the Treatment of Mammary Duct Fistulas: A Combination of Microwave and Ultrasound

Berna, Juan D.; Berna Jr., Juan D.; Sanchez, Juan; Madrigal, Manuel; Rodenas, Javier
October 2002
American Surgeon;Oct2002, Vol. 68 Issue 10, p897
Academic Journal
Between 1994 and 1999, 11 women with recurrent mammary duct fistula underwent nonsurgical treatment with microwave and ultrasound. An initial ultrasonographic examination was performed during the recurrence of mammary duct fistula, and in ten cases it revealed a small superficial periareolar anechoic, hypoechoic, or heterogenic lesion with poorly defined edges and without posterior reinforcement (marked distal sound enhancement). Findings indicated an extraglandular inflammatory process; duct ectasia was not seen in any of the 11 patients. A combination of microwave and ultrasound was administered on an outpatient basis for 20 days. Clinical improvement was rapid after the first few sessions of treatment. In nine of the 11 patients there has been no recurrence during more than 2 years of follow-up. The two current episodes were resolved by a second application of the same treatment. In one of those patients (with recurrence at 6 months) an infiltration of steroids was also administered, and this patient is without recurrence after 23 months' follow-up.


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