A 35-year-old patient presents to your office with chronic draining subcutaneous periareolar abscesses, which have been incised and drained many times in the past 5 years but keep recurring. What is the best treatment of choice?
Mammary fistula also known as Zuska's disease is felt to represent dilated laciferous ducts, which develop chronic inflammation presenting with these periareolar draining sinuses. They will continue to recur until completely excised, which may require removal of the terminal duct into the nipple, leaving the wound open.
Repeat incision and drainage (I and D) since the previous procedures were inadequate
Long-term antibiotics
Major duct excision
Complete excision of the drainage tract
Breast