title: Breast duct endoscopy: ductoscopy from a diagnostic to an interventional procedure and its future perspective.
abstract: OBJECTIVE
  Breast duct endoscopy is increasingly used for evaluation of intraductal disease. We present a new rigid instrument for ductoscopy that allows intraductal biopsy and the removal of small lesions.
  
  
  METHODS
  Overall, 102 women with breast cancer or pathologic nipple discharge were included in the analysis. All ductoscopies were performed with a rigid gradient index micro-endoscope (phi 0.7 mm) in combination with a special device for intraductal vacuum assisted biopsy. Ductoscopy, ductal lavage and intraductal biopsy were correlated with ductal cytology and histopathology of the resection specimen.
  
  
  RESULTS
  Gradient index ductoscopy provided high resolution images of the breast ducts and identified additional intraductal lesions in 45% of the patients with breast cancer. The accuracy of ductal lavage, ductoscopy and mammography in the detection of an extensive intraductal component was 14%, 65% and 50%, respectively. Intraductal vacuum assisted biopsy yielded diagnostic material in 92% of 38 patients with nipple discharge and papillomatous lesions. Histology of the resection specimen confirmed the diagnosis in all cases including 2 in situ carcinoma and 2 invasive ductal carcinoma.
  
  
  CONCLUSIONS
  Ductoscopy is a useful supplement for the standard radiological workup of breast cancer especially in patients with extensive intraductal carcinoma. Ductoscopic vacuum assisted biopsy is an effective technique for intraductal tissue sampling and allows ablation of small lesions. This technique provides new perspectives for interventional therapy of intraductal tumours.
authors.affiliation: Department of Surgery and Surgical Oncology, Helios Hospital Berlin-Buch, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Dubowy
authors.forename: M
authors.initials: M
authors.lastname: Raubach
authors.forename: T
authors.initials: T
authors.lastname: Topalidis
authors.forename: T
authors.initials: T
authors.lastname: Lange
authors.forename: S
authors.initials: S
authors.lastname: Eulenstein
authors.forename: M
authors.initials: M
authors.lastname: Hünerbein
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009558:Nipples / Q000473:pathology*; D018300:Papilloma, Intraductal / Q000175:diagnosis* / Q000601:surgery; D015203:Reproducibility of Results; D055815:Young Adult