Excision of the major ductal system of the breast as described by Hadfield in 1960 is associated with
several complications, such as loss of sensation in many women, nipple retraction in 10% and necrosis of aerola-nipple
complex. In order to reduce such complications, we have modified the classical Hadfield technique. The basic difference
is advancement of the aerola-nipple complex as a flap into a new bed immediately above the incision across the upper half
of aerola-skin junction. The results of 46 operations performed for 33 patients (13 patients had bilateral operation) were
satisfactory. After a mean follow up of 3.5 years, loss of sensation occurred in two patients (4%) epithelial necrosis of
the upper half of the aerola in one patient (2%) and recurrence of discharge in another patient (2%). No episodes of wound infection or nipple retraction were reported in this study. The results demonstrate the effectiveness of this technique as an appropriate alternative to classical Hadfield operation
