Modified Techniques Versus Hadfield’s Procedure in Patients With Periductal Mastitis

Background: Periductal mastitis (PM) is a rare disease characterized by chronic inflammation of the terminal mammary ducts. Complete removal of the terminal canals with Hadfield’s operation applied in the treatment carries various complication risks. This study is designed to evaluate the effectiveness of modified techniques and compare them with the Hadfield operation. Methods: : Twenty women who underwent surgery due to PM between January 2012 and December 2019 were retrospectively analyzed. Types of PM were determined. All patients were operated on with three different incisions (Hadfield’s operation with periareolar incision, periareolar combined with radial incision, and round block incision). Results: : The age mean 37.5±6.5 years (range:24-49). Sixty percent of patients had type three PM. For the affected duct excision, a classic Hadfield’s operation with periareolar incision was performed in 11 patients, periareolar incision combined with radial incision was performed in 7 patients. The round block method was performed on two patients. Seroma was observed in only one of the patients who underwent the modified technique. In Hadfield’s procedure, NAC retraction (n:2), seroma (n:1), and hematoma (n:1) were seen. The follow-up period was 12±1.5 months. Recurrence occurred in two patients, and both had Hadfield’s procedures. Conclusions: : The main principle of surgical treatment is excision of the affected canal with a clear margin. In PM treatment, The round block method and periareolar incision combined radial incision modifications of the Hadfield procedure reduce complications and recurrence risk.