Abstract

SAFETY AND EFFECTIVENESS OF PROLENE THREAD PROBING (AISHAN KARMA) IN THE MANAGEMENT OF DUCTAL ECTASIA: A SINGLE CASE REPORT

*Dr. Bhushan Kasbe, Dr. L. R. Soni

Abstract

Background: Mammary duct ectasia is a non-neoplastic disorder of the breast characterized by dilatation of the major lactiferous ducts accompanied by chronic inflammation and retention of inspissated secretions. Patients commonly experience nipple discharge, periareolar pain, tenderness, or nipple inversion, and recurrent symptoms may eventually require surgical intervention. Ayurveda emphasizes the restoration of normal channel patency (Srotoshodhana) in conditions resulting from obstruction. The surgical principle of Aishan Karma described by Acharya Sushruta provides a conceptual basis for gently exploring and relieving obstructed passages. The present report describes the use of a sterile prolene thread as a minimally invasive probing technique for symptomatic ductal ectasia. Aim: To assess the safety and clinical effectiveness of prolene thread probing (Aishan Karma) in a patient with symptomatic ductal ectasia. Case Description: A 43-year-old woman presented with intermittent pain in the right breast, sticky yellowish nipple discharge, mild nipple retraction, and recurrent periareolar discomfort for six months. Breast ultrasonography demonstrated dilatation of the central lactiferous duct with retained secretions and without abscess formation or suspicious solid lesion. After appropriate clinical evaluation and informed consent, gentle probing of the affected duct using a sterile prolene thread was performed under aseptic conditions to restore ductal patency, followed by evacuation of retained secretions. Appropriate Ayurvedic oral medications and local care were advised during follow-up. Results: The procedure was completed without intraoperative or postoperative complications. Pain progressively subsided, nipple discharge resolved completely, nipple retraction improved, and follow-up ultrasonography demonstrated a reduction in duct calibre. Conclusion: Prolene thread probing based on the principle of Aishan Karma may represent a safe, simple, and minimally invasive option for carefully selected patients with symptomatic ductal ectasia. Further studies involving larger patient populations are necessary to validate these preliminary observations.

Keywords: Ductal ectasia, Aishan Karma, Eshana Karma, Prolene thread, Breast surgery, Ayurvedic Shalya Tantra.