title: The clinical applications of mammary ductoscopy.
abstract: BACKGROUND
  Mammary ductoscopy (MD) is a newly developed endoscopic technique that allows direct visualization and biopsy examination of the mammary ductal epithelium where most cancers originate. The procedure can be performed under local anesthesia in the office setting. This article reviews the rationale, current clinical applications, and limitations of MD.
  
  
  METHODS
  A literature search was performed using Pubmed for indexed articles published over the past 30 years using the key words "mammary ductoscopy," "breast ductoscopy," "ductal lavage," and "nipple aspiration." The most important articles were analyzed and discussed.
  
  
  RESULTS
  MD is a useful diagnostic adjunct in patients with pathologic nipple discharge. Furthermore, it can reduce the number and extent of duct excision surgeries for pathologic nipple discharge. There is a clear need to design prospective clinical trials that evaluate the potential role of MD in breast cancer screening, guiding risk-reducing strategies, and as an adjunct to breast-conservation surgery.
  
  
  CONCLUSIONS
  MD is useful in the management of PND, but its potential role in the early detection or management of breast cancer requires further investigation.
authors.affiliation: The Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Pedro F
authors.initials: PF
authors.lastname: Escobar
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Crowe
authors.forename: Tadaharu
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Kefah
authors.initials: K
authors.lastname: Mokbel
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D004724:Endoscopy / Q000379:methods*; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D042361:Mammary Glands, Human / Q000473:pathology*; D015412:Mastectomy, Segmental; D009558:Nipples / Q000473:pathology; D018570:Risk Assessment