A randomized controlled study of selective microdochectomy guided by ductoscopic wire marking or methylene blue injection.
BACKGROUND
Methylene blue identification of lesions during microdochectomy is often inaccurate, resulting in large dissection and tissue damage. A wire placed via ductoscopy preoperatively into the pathologic duct may aid identification and reduce the amount of dissection required.


METHODS
A total of 53 patients being evaluated for nipple discharge were randomized to receive ductoscopy with either methylene blue or wire marking of the lesion before microdochectomy. Patient clinical characteristics and surgical outcomes were evaluated.


RESULTS
There were 28 patients who received methylene blue marking and 25 who received wire marking of the lesions. There were no differences between the demographic or clinical characteristics of the groups. Wire marking was associated with less surgical time, smaller incisions, and smaller surgical specimens, but the same diagnostic accuracy.


CONCLUSIONS
Wire marking of lesions for microdochectomy is associated with less dissection and tissue damage than methylene blue, yet the same diagnostic accuracy.
Zhu
Xun
X
Department of General Surgery, The Second Affiliated Hospital of Soochow University, Jiangsu, People's Republic of China. zhuxun1023@126.com
Xing
Chungen
C
Jin
Tao
T
Cai
Lichun
L
Li
Juncheng
J
Chen
Qiang
Q
D000328:Adult; D000368:Aged; D001941:Breast Diseases / Q000175:diagnosis / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004396:Coloring Agents; D004724:Endoscopy / Q000379:methods*; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D042361:Mammary Glands, Human / Q000473:pathology / Q000601:surgery; D008327:Mammography; D008751:Methylene Blue; D008875:Middle Aged; D009558:Nipples / Q000473:pathology / Q000601:surgery; D016217:Ultrasonography, Mammary
D004396:Coloring Agents; D008751:Methylene Blue