Hadfield’s procedure (total duct excision)

This is a procedure performed to disconnect the ducts behind your nipple. This is performed to remove benign papillomas of the breast, to reach a diagnosis for nipple discharge, as treatment for reoccurring breast abscess and to stop the nipple discharge. The procedure is performed under a general anaesthetic. A surgical cut is made on the edge of the dark area surrounding the nipple (areola), and the ducts behind the nipple are removed. The skin is then closed with self-dissolving stitches under the skin. The ducts removed will then be tested under the microscope and the results will be discussed with you at your clinic appointment.

Prior to the procedure

No special procedure is required prior to this operation. Smoking cessation is important if you are a smoker as it helps reduce the risk of wound complications.

Recovery

After the procedure you will wake up in a hospital room. After a hadfield’s procedure you may go home on the same day or spend one night in hospital. You are typically expected to go home once you are eating and drinking and are able to manage the pain. It normally takes about two weeks to fully recover and return back to work but it varies from person to person and depends on their general health and the nature of their work. Once at home it is important to get adequate rest and perform shoulder exercises to reduce the risk of getting a stiff shoulder. For the first four weeks you should avoid any heavy lifting or repetitive movements (ironing, vacuuming), avoid swimming or playing sport, avoid driving until you are confident.

Risks of the procedure

Hadfield’s procedure is in general a very safe procedure. Complications common to all surgical procedures include risk of wound infection (2%), bleeding/bruising (1%), blood clots, heart problems, pneumonia and anaesthetic risks. The complications specific to this operation include short term pain, a scar, inversion of the nipple, loss of sensation around the nipple area and/or in very rare occasions loss of the nipple as the blood supply may be interrupted and it may need to be removed.