Should mastitis be allowed to rupture spontaneously or should surgical incision be performed?

Generally, whether a milk fistula (lactiferous fistula) should be allowed to rupture spontaneously or requires surgical incision depends on the specific circumstances. If the lesion is small and symptoms are mild, spontaneous rupture may be permitted. However, if the lesion is large and symptoms are severe, surgical intervention is necessary. The detailed analysis is as follows:

1. Spontaneous Rupture

If the milk fistula is small and symptoms are mild, treatment may involve allowing it to rupture spontaneously. When internal pressure increases within the lesion, the small ducts around the nipple may rupture naturally, enabling the drainage of milk and thereby relieving symptoms. After spontaneous rupture, it is important to clean the wound promptly and maintain cleanliness and hygiene of the breast area to prevent infection. Additionally, medical treatment such as oral antibiotics may be used to promote healing.

2. Surgical Incision

If the milk fistula is large and symptoms are severe, surgical treatment may be required. Surgery can be performed under local or general anesthesia. During the procedure, the doctor will make an incision at the affected site, thoroughly remove accumulated fluid and inflamed tissue, and then suture the wound. Postoperatively, proper wound care is essential—keeping the wound clean to avoid infection—and patients should follow the doctor’s instructions regarding medication and wound management.

In summary, small milk fistulas with mild symptoms may be treated by allowing spontaneous rupture, whereas larger lesions with more severe symptoms may require surgical treatment. Patients experiencing discomfort or symptoms are advised to seek prompt medical attention at a hospital.