TOTAL DUCT EXCISION

A retrospective review of case records was performed of 110 patients w ho underwent 124 total duct excisions during the period 1989-1995. All patients were sent a questionnaire and 88 fully completed questionnai res from 100 total duct excisions were analysed. All operations were p erformed according to a standard technique utilizing a circumareolar i ncision and all operations were performed under antibiotic cover. Imme diate postoperative wound morbidity was low with only 4 wound infectio ns. Of the 100 operations assessed from the questionnaires. 94 patient s rated the cosmetic result as excellent or good. Nipple sensation imp roved after 24 operations but decreased or was absent after 26 operati ons. Patients who reported pain prior to operation, those who smoked a nd those who had a past history of multiple episodes of periareolar se psis were significantly more likely to have decreased nipple sensation following surgery (P = 0.045, P = 0.015 and P = 0.007, respectively). Patients who reported that the position of the nipple was improved by surgery were significantly more likely to report improvement in nippl e sensation (P = 0.01). Total duct excision is an operation that can b e performed with acceptable postoperative wound complications but is a ssociated with significant changes in nipple sensation, and patients s hould be wanted of this.