title: Identification of breast cancer in patients with pathologic nipple discharge: does ductoscopy predict malignancy?
abstract: OBJECTIVE
  The purpose of the current study was to review characteristics of patients with nipple discharge who underwent ductoscopy-assisted excisional biopsy who had a final diagnosis of carcinoma.
  
  
  METHODS
  A retrospective review was performed of patients presenting with pathologic nipple discharge (PND) who underwent ductoscopy-assisted excisional biopsy and had a final diagnosis of carcinoma.
  
  
  RESULTS
  A total of 14 (7%) of 188 patients who underwent ductoscopy-assisted excision had a final pathology of ductal carcinoma-in-situ (DCIS) (12/14, 86%) or invasive breast cancer with DCIS (2/14, 14%). Duct wall irregularities or intraluminal growths were visualized during ductoscopy in 8 of the 14 (57%) breast cancer patients. There were no visual abnormalities noted during ductoscopy that accurately predicted a final diagnosis of malignancy.
  
  
  CONCLUSIONS
  Although occult malignancies can be identified in patients undergoing ductoscopy-assisted biopsy for PND, no clear morphologic changes visualized during ductoscopy definitively indicated the presence of malignancy.
authors.affiliation: Department of Surgery, The Cleveland Clinic, Cleveland, OH 44106-5047, USA.
authors.forename: Lana D
authors.initials: LD
authors.lastname: Louie
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Crowe
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Dawson
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Lee
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Baynes
authors.forename: Tami
authors.initials: T
authors.lastname: Dowdy
authors.forename: Julian A
authors.initials: JA
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D004724:Endoscopy; D005122:Exudates and Transudates / Q000378:metabolism*; D005260:Female; D006801:Humans; D042361:Mammary Glands, Human / Q000473:pathology*; D009558:Nipples / Q000378:metabolism*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D007507:Therapeutic Irrigation