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The histology obtained from 1256 female patients undergoing breast surgery was reviewed. Mammary duct ectasia was noted in 51 (4.2%) patients who had associated symptoms and in 103 (8.1%) patients where duct ectasia was recognized as an incidental finding. The syndrome is defined by primary (nipple change or sepsis) and secondary (pain and lump) symptoms. Formal duct excision gives good results for symptomatic duct ectasia. It is postulated that many women have nonsymptomatic mammary duct ectasia. Secondary infection gives rise to nipple change, lump and pain. In the severe form abscess and fistula formation occurs which necessitates repeated surgical treatment, and rarely mastectomy.