Fiona, just plunged into Dr. Miriam Stoppard's 'The Breast Book' 1996.  She
goes into great depth describing Dilatation of the Milk Ducts - Ectasia. Also
Mammary Duct Fistula.  Does this mother smoke or a passive smoker?  Is she
diabetic or immune system compromised.  Apparently, we are most at risk of non
lactation mastitis, ectasia and duct fistulae if diabetic or if one has
compromised immune system, breast surgery or diabetes or smoke/passive smoker.
Ectasia apparently will not heal if you are a smoker.Can you not refer her to
a specialist Breast Clinic or ask NMAA contacts for recommendations?
Mastectomy!!   Rather go for 2nd, 3rd opinion or major duct excision with
counselling beforehand on outcome of surgery.
Good Luck to her, best wishes, Helen M. Woodman, National Childbirth Trust
Breastfeeding Counsellor, UK.