title: Diagnostic value of ductoscopy in the diagnosis of nipple discharge and intraductal proliferations in comparison to standard methods.
abstract: BACKGROUND
  Ductoscopy is gaining increased importance in the diagnosis of nipple discharge of unclear origin and intraductal proliferation. For this reason we compared its diagnostic value and feasibility to standard diagnostic methods.
  
  
  METHODS
  Ductoscopy was compared to mammography, galactography, sonography, magnetic resonance imaging (MRI), nipple smear, fine needle aspiration cytology (FNAC), and high-speed core biopsy; feasibility, sensitivity, and specificity were investigated for each method.
  
  
  RESULTS
  71 ductoscopies were evaluated, which were followed up by open biopsies. Here, 3 invasive and 8 ductal carcinomas in situ were found, as well as 3 atypical ductal hyperplasias, 44 papillomas/papillomatoses, and 13 benign findings. Feasibility of ductoscopy was in this series 100%. Duct sonography showed the highest sensitivity (67.3%), followed by MRI (65.2%), galactography (56.3%), ductoscopy (55.2%), and FNAC (51.9%). The highest specificity was shown by FNAC, core biopsy, and galactography (each 100.0%), followed by mammography (92.3%), nipple smear (77.8%), ductoscopy, and duct sonography (each 61.5%); the lowest specificity was displayed by MRI (25.0%).
  
  
  CONCLUSIONS
  The results confirm that ductoscopy can be performed within the same range of sensitivity and specificity as other techniques. In order to make conclusive statements about ductoscopy, especially in order to precisely define the indications for this method, a prospective multicenter study was initiated.
authors: Department of Obstetrics and Gynecology, Ernst Moritz Arndt University, Greifswald, Germany.
authors: Susanne
authors: S
authors: Grunwald
authors: Hans
authors: H
authors: Heyer
authors: Stefan
authors: S
authors: Paepke
authors: Günther
authors: G
authors: Schwesinger
authors: Anette
authors: A
authors: Schimming
authors: Markus
authors: M
authors: Hahn
authors: Anke
authors: A
authors: Thomas
authors: Volker R
authors: VR
authors: Jacobs
authors: Ralf
authors: R
authors: Ohlinger
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001941:Breast Diseases / Q000175:diagnosis / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating; D002455:Cell Division / Q000502:physiology*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D004724:Endoscopy; D005260:Female; D005687:Galactorrhea / Q000209:etiology* / Q000473:pathology; D006801:Humans; D042361:Mammary Glands, Human / Q000473:pathology; D008875:Middle Aged; D009558:Nipples / Q000473:pathology; D018300:Papilloma, Intraductal / Q000175:diagnosis* / Q000473:pathology; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity