"Non-puerperal mastitis, also known as Zuska disease, Zuska-Atkins disease, or squamous metaplasia of lactiferous ducts (SMOLD), is a rare benign breast condition characterised by recurrent subareolar abscess formation, sometimes followed by chronic fistula formation and pus drainage. It is considered part of the spectrum of inflammatory breast processes unrelated to lactation."
"The pathogenesis of non-puerperal mastitis involves squamous metaplasia of the normal cuboidal epithelium lining the lactiferous ducts. The large amount of keratin produced by the squamous lining obstructs and dilates the ducts, leading to acute inflammatory infiltrates and cellular debris with secondary bacterial infection resulting in abscess formation. The abscess may drain spontaneously and with time can develop into a peri-areolar cutaneous sinus or fistula 2,4,6."
"At MRI, most commonly reported findings are that of non-mass enhancement with regional distribution and heterogenous internal enhancement 4,8. Non-puerperal mastitis typically exhibits type 1 and 2 kinetic curves."
"Some studies recommend early surgical intervention with excision of the abscess, sinus tract and and the involved terminal portion of the subareolar duct because of the high recurrence rate with medical treatment. Whilst others emphasise medical management initially including abscess drainage and antibiotic treatment, with surgical management reserved for cases in which medical management fails and cases of discharge from multiple ducts 4,9."
"Non-puerperal mastitis is a relatively uncommon benign breast entity, representing 1-2% of all symptomatic breast processes 1. Despite being benign, it is an important source of prolonged morbidity. It is seen more commonly in females, with a mean age of presentation of 47 years old 2; however, case reports of male disease have also been reported in the literature 3."
"There is a reported strong correlation with cigarette smoking 4,5 and possible association with inadequate vitamin supplementation (particularly vitamin A) also suggested 4,6."
"There is very little published literature regarding imaging findings of non-puerperal mastitis with varying imaging manifestations described."
"There is no consensus on the appropriate treatment of nonpuerperal mastitis in the literature."
"At ultrasound, most commonly reported are that of discrete subareolar or areolar skin collections, most with associated with overlying skin thickening, or either as solitary, separated, contiguous or clustered, hypoechoic mass-like lesions 7. Rarely, isolated skin thickening is the primary finding 4."
"At ultrasound, most commonly reported are that of discrete subareolar or areolar skin collections, most with associated with overlying skin thickening, or either as solitary, separated, contiguous or clustered, hypoechoic mass-like lesions 7. Rarely, isolated skin thickening is the primary finding 4."
"History and etymology"