Pathogenesis
The duct widening is commonly believed to be a result of secretory stasis, including stagnant colostrum, which also causes periductal inflammation and fibrosis. However because nonspecific duct widening is common it might be also coincidental finding in many processes.
Smokers seem more often affected by duct ectasia syndrome although the reported results are not entirely consistent. The correlation with smoking status appears weaker than for subareolar abscess. Correlation with the actual duct widening is not known.
Both duct widening and duct ectasia syndrome are frequently bilateral, hence systemic causes are likely involved.
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