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Microdochectomy is a surgical procedure performed to remove a lactiferous duct in the breast, often used to investigate and manage persistent nipple discharge. This involves the extraction of a single milk duct through a small incision in the areolar edge, typically under local or general anaesthesia. The excised duct is then sent for pathological analysis to rule out any malignancy.
Microdochectomy is primarily carried out to address persistent and troublesome nipple discharge. Reasons for the procedure include:
Unexplained discharge, particularly if it’s spontaneous, unilateral or bloodstained, may require microdochectomy for further evaluation.
When imaging or cytological tests fail to diagnose the cause of nipple discharge, a microdochectomy may be necessary.
This benign condition, characterised by a small wart-like growth in the milk ducts, is a common cause of nipple discharge. A microdochectomy can effectively remove the affected duct.
Eligibility for microdochectomy generally depends on several factors.
During the procedure, the patient is placed under local or general anesthesia. The surgeon then makes a small incision around the edge of the areola and locates the affected milk duct, often using discharge as a guide. The milk duct is carefully extracted and the incision is closed using fine sutures. The entire procedure typically lasts about an hour.
The recovery process following a microdochectomy typically includes the following stages:
There may be some discomfort, but this can generally be managed with over-the-counter painkillers.
The patient may experience slight swelling and bruising. Wearing a supportive bra can aid in comfort during this period.
Any non-dissolvable stitches will usually be removed at this time. Patients can typically return to normal activities, although heavy lifting or strenuous exercise should be avoided.
Swelling and bruising should gradually subside. Any residual pain should also decrease during this period.
Consult our MOH-accredited breast surgeon for a comprehensive evaluation & personalised treatment plan.
Dr Jesse specialises in managing both benign and malignant breast and thyroid conditions, which also includes breast pain, breast lumps, breastfeeding problems, neck lumps, amongst others.
Her dual expertise in cancer removal and plastic surgery techniques expands the design of individualized treatments, leading to holistic patient outcomes.
Dr Jesse was part of the teaching faculties of both NUS Yong Loo Lin School of Medicine and Lee Kong Chian School of Medicine, where she teaches and mentors the next generation of medical students and trainee doctors.
Dr Jesse is recognized as an authority in breast cancer and thyroid surgery and a sought-after conference speaker.
Dr Felicia is actively involved in promoting breast cancer awareness. She has also been invited to give lectures and public talks on breast cancer related issues both locally and internationally.
Her clinical interest lies in treatment of breast cancer and the use of various surgical techniques to achieve the best oncologic and cosmetic outcome for her patients.
She is the pioneer of the procedure radioisotope occult lesion localisation (ROLL) in Singapore – which is used for locating non-palpable breast lesions and micro-calcifications for surgical excision.
She is also adept with the whole range of breast surgical procedures including vacuum assisted biopsies and endoscopic (key-hole) breast surgery for breast lesions.
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As the procedure involves the removal of a milk duct, it may affect the ability to breastfeed from the treated breast.
The surgeon will attempt to place the incision in a less noticeable area, typically along the edge of the areola. Over time, the scar should fade and become less noticeable.
As with any surgery, potential risks include infection, bleeding, and an adverse reaction to anaesthesia. There may also be changes in breast and nipple sensations.
Microdochectomy is not a procedure to prevent breast cancer. It can help diagnose breast cancer if the nipple discharge is due to a malignant cause.
