Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb 28;9(3):649.
doi: 10.3390/jcm9030649.

A New Treatment for Mammillary Fistulas Using Ultrasound-Guided Percutaneous Needle Electrolysis

Juan de Dios Berná-Serna  1   2 , José A García-Vidal  2   3 , María P Escolar-Reina  2   3 , Francesc Medina-Mirapeix  2   3 , Florentina Guzmán-Aroca  1   2 , Antonio Piñero-Madrona  2   4 , Juan de Dios Berná-Mestre  1   2
Affiliations

A New Treatment for Mammillary Fistulas Using Ultrasound-Guided Percutaneous Needle Electrolysis

Juan de Dios Berná-Serna et al. J Clin Med. .

Abstract

The aim of this study was to investigate the efficacy of ultrasound-guided percutaneous needle electrolysis (PNE) in mammillary fistulas (MFs). A prospective study was performed in 18 patients with MF who were treated with the PNE technique. The technique was repeated in the case of no response or recurrence. The results obtained show that MFs revealing an elongated appearance with the ultrasound (US) are generally resolved with two sessions of PNE, whereas ovoid MFs require several sessions of PNE for complete resolution and they tend to recur. Success of the treatment with PNE was observed in 88.8% of the patients (16/18), and failure, after five or six sessions in two cases (11.2%), which were referred for surgery. Conclusions: To the best of our knowledge this is the first study to reveal that the PNE technique is safe, effective, quick, and well-tolerated by patients.

Keywords: breast; mammillary fistulas; percutaneous needle electrolysis; ultrasound.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
(A) Percutaneous needle electrolysis (PNE) unit employed in the study and electrodes; (B) needle holder (cathode), adapter to connect the needle to the needle holder and needle with the safety shield moved to the base of the needle; (C) patient holding a hand-held anode; (D) 46-year-old woman with a mammary fistula (MF); (E) PNE treatment.
Figure 2
Figure 2
Example of PNE of an MF: (A) the ultrasound image shows a hypoechoic elongated appearance; (B) needle inserted into the track distal zone; (C) hyperechoic image over the needle after application of PNE.
Figure 3
Figure 3
Flow diagram of the patients in this study.
Figure 4
Figure 4
Kaplan–Meier survival curves demonstrating remissions over a period of 26 weeks, according to fistula appearance: elongated (solid line) and ovoid (dashed line).
Figure 5
Figure 5
Kaplan–Meier survival curves demonstrating remissions over the number of additional PNE sessions, according to fistula appearance: elongated (solid line) and ovoid (dashed line).
Figure 6
Figure 6
Example of an ovoid MF on ultrasound that was referred for surgery.
See this image and copyright information in PMC

References

    1. Bundred N.J., Dixon J.M., Chetty U., Forrest A.P.M. Mammillary fistula. Br. J. Surg. 1987;74:466–468. doi: 10.1002/bjs.1800740611. - DOI - PubMed
    1. Lannin D.R. Twenty-two year experience with recurring subareolar abscess and lactiferous duct fistula treated by a single breast surgeon. Am. J. Surg. 2004;188:407–410. doi: 10.1016/j.amjsurg.2004.06.036. - DOI - PubMed
    1. Versluijs-Ossewaarde F.N., Roumen R.M., Goris R.J. Subareolar breast abscesses: Characteristics and results of surgical treatment. Breast J. 2005;11:179–182. doi: 10.1111/j.1075-122X.2005.21524.x. - DOI - PubMed
    1. Kasales C.J., Han B., Smith J.S., Jr., Chetlen A.L., Kaneda H.J., Shereef S. Nonpuerperal mastitis and subareolar abscess of the breast. Am. J. Roentgenol. 2014;202:W133–W139. doi: 10.2214/AJR.13.10551. - DOI - PubMed
    1. Hanavadi S., Pereira G., Mantel R.E. How mammillary fistulas should be managed. Breast J. 2005;11:254–256. doi: 10.1111/j.1075-122X.2005.21641.x. - DOI - PubMed

LinkOut - more resources