DOI: https://doi.org/10.36347/sasjm.2026.v12i05.018

Pages: 460-464

Zuska’s disease is a chronic non-puerperal subareolar mastitis characterized by recurrent abscess formation and fistulization of lactiferous ducts. It predominantly affects middle-aged women and is strongly associated with smoking, which plays a central role in its pathogenesis. We report the case of a 47-year-old woman with a history of heavy smoking and recurrent left breast abscesses over a 12-year period. Imaging findings, including ultrasound and mammography, confirmed the diagnosis and excluded malignancy. The underlying mechanism involves squamous metaplasia of lactiferous ducts (SMOLD), leading to keratin plug formation, ductal obstruction, and secondary infection. Management is based on antibiotics and image-guided drainage, while surgery is reserved for recurrent or complicated cases. Smoking cessation remains essential to prevent recurrence.