Scarless endoscopic papillomectomy of the breast.
BACKGROUND
Efforts have been made to improve minimally invasive breast surgery techniques, resulting in less tissue damage and much better cosmetic results. We evaluated the therapeutic value of a new scarless operation, endoscopic papillomectomy (EP), in patients with pathologic nipple discharge (PND).


METHODS
Breast ductoscopy was performed on 126 women with PND. These patients underwent a variety of appropriate ductoscopy-assisted (DA) endosurgical interventions, combined with cytologic examinations. Success was determined by recurrence of PND and by standard radiological examinations.


RESULTS
Ductoscopy was successfully performed in 102 patients. Of these 102 patients, 26 had solitary papillomas (SP), 5 had multiple papillomas (MP), 11 had intraductal debris, and 1 had a ductal epithelial surface abnormality with positive cytology. Of the 26 polypoid lesions (cytology negative), 22 were excised endoscopically (endoscopic papillomectomy). Patients with MP underwent DA-microdochectomy. Except in one patient, all discharges disappeared. After a mean +/- SD follow-up time of 11.5 +/- 5.8 months (range 2-22 months), there were no recurrences of nipple discharge and no radiological results suggestive of malignancy. Thus, the therapeutic efficacy of EP in our study was 95.4% (21/22).


CONCLUSIONS
Ductoscopy is not only a diagnostic procedure, but is also therapeutic for breast papillomas. EP is a new scarless treatment option for patients with PND.
Bender
Omer
O
First Department of General Surgery, S. B. Okmeydani Training and Research Hospital, Istanbul, Turkey. omerbender@hotmail.com
Balci
Fatih Levent
FL
Yüney
Enis
E
Akbulut
Hasan
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D018300:Papilloma, Intraductal / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome