Ayurvedic Management of Mammary Duct Ectasia (Stana Shotha): A Case Report

Background: Mammary duct ectasia is a benign disorder characterized by dilatation and inflammation of larger lactiferous ducts. It commonly presents with nipple discharge, breast tenderness and periareolar inflammation and may mimic breast malignancy. Persistent symptomatic cases may require surgical duct excision. Case Presentation: A 46-year-old premenopausal woman presented with spontaneous, persistent greenish serous discharge from the right nipple with breast tenderness for two months. Previous intermittent treatment with anti-inflammatory drugs and antibiotics provided no satisfactory relief. Examination revealed localized right breast erythema and tenderness without a palpable mass, abscess, fistula, nipple retraction or lymphadenopathy. Thyroid function and serum prolactin were normal. Sonomammography showed mild bilateral retroareolar duct ectasia (3–4 mm) containing anechoic fluid, without intraductal mass or vascularity, suspicious lesion or significant axillary lymphadenopathy (BI-RADS 2). Cone excision was advised; however, the patient opted for Ayurvedic treatment. Intervention: Shodhan and Shaman Chikitsa were administered. Raktamokshana was performed by Jaloka Avacharana using two leeches locally. Shaman Chikitsa comprised Sukshmatriphala 500 mg twice daily and Gandhak Rasayan 500 mg twice daily for 21 days. Outcome: Discharge and erythema resolved within 7 days, while pain and tenderness resolved by day 15. At 21 days, complete clinical resolution was noted. Follow-up sonomammography showed no significant ductal dilatation or intraductal lesion (BI-RADS 1). No recurrence was observed at 3, 6 and 12 months. Conclusion: Ayurvedic treatment with Jaloka Avacharana and Shaman Chikitsa resulted in complete and sustained clinical and radiological resolution in this case. Larger prospective studies are required to establish its efficacy.