I saw a patient in clinic for a "breast lump".  It
turned out to be an inflamed subareolar sebaceous
cyst.  It was quite tender and draining purulent,
bloody sebaceous material.  She was treated for this
and it resolved.  

However, what puzzled me was that on exam, both
breasts produced fairly substantial amounts of thick,
cheesy, yellowish-white sebaceous type material from
the milk ducts.  This material could be gently
expressed from all of the milk ducts on both breasts.
It was clearly sebaceous material by the appearance
and characteristic odor.  The patient, in her early
40's, reported that she'd has such discharge ever
since weaning her last baby around 10 years prior. 
She regularly noticed it, but it caused her no
discomfort or concern until the cyst appeared.  This
was her first occurance of a cyst.  She was referred
back to her gynecologist who did a follow-up exam and
obtained a mammogram, which was normal.

I had never encountered this before.  Have others seen
women with this type of discharge?  Is there anything
that can or should be done about it, other than the
follow-up as described above?  It seems to be entirely
asymptomatic except for the formation of the one cyst.

Catharine Decker, MD
Family Medicine/Urgent Care
Luther Midelfort/Mayo Health Systems  


       
____________________________________________________________________________________
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