Saturday, January 30, 2010

Milk Fistula

A milk fistula is a tract between the skin and a lactifenous duct. Milk fistulas usually form during lactation, often as a result of surgical intervention, but has also been seen after large-core needle biopsy. Peripheral lesions have a much lower risk of developing milk fistulas after open biopsy compared to deep, central lesions

While spontaneous closure has occurred during lactation, the only reliable way of closure is suppression of lactation. Lactation can be suppressed with breast binding and withholding sucking stimuli, or the use of bromocriptine. The former method usually takes about a week, but the patient may feel discomfort from breast engorgement during this time. Bromocriptine therapy takes about two weeks and may result in nausea in about 5% of patients and carries a slight risk of cardiovascular side effects.


Schackmuth EM, Harlow CL, Norton LW. Milk fistula: a complication after core breast biopsy. AJR Am J Roentgenol. 1993 Nov;161(5):961-2.

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