Diagnostic and therapeutic value of ductoscopy in nipple discharge and intraductal proliferations compared with standard methods.
BACKGROUND
Fiberoptic ductoscopy is a practical and direct approach that allows the visualization of intraductal breast disease. The aim of this study was to assess the efficacy of ductoscopy in the diagnosis and management of intraductal lesions.


METHODS
Data on 357 ductoscopic investigations from patients with nipple discharge were collected prospectively. Seventy-five patients were diagnosed as having intraductal papillary lesions and these cases were evaluated by final histopathology (55 solitary, 14 multiple papillomatosis, 6 premalignant or malignant lesions). Results of classical diagnostic studies using ultrasonography, mammography, and galactography were compared with those of ductoscopy and pathology.


RESULTS
The sensitivities of investigation methods for papillomas in this study were 72 % in ultrasonography, 62.9 % in mammography, 81.4 % in galactography, and 86.6 % in ductoscopy. With ductoscopic papillomectomy (DP), almost 30 % of patient with solitary papilloma did not require further extensive surgery.


CONCLUSIONS
Since there is an increased risk of malignancy, surgical excision is recommended for multiple, larger papillomas and for papillomas with atypia and in addition for papillomas where diagnostic tools produce suspicious findings. On the other hand DP is a minimally invasive intervention and can aid in the follow-up of lesions proven to have no atypia.
Department of Surgery, SB Okmeydani Training and Research Hospital, Istanbul, Turkey, kamalisedat@yahoo.com.
Sedat
S
Kamali
Omer
O
Bender
Gülcin Harman
GH
Kamali
Mehmet Timucin
MT
Aydin
Oguzhan
O
Karatepe
Enis
E
Yuney
D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D042361:Mammary Glands, Human / Q000473:pathology; D008327:Mammography; D009558:Nipples / Q000000981:diagnostic imaging / Q000473:pathology*; D018300:Papilloma, Intraductal / Q000473:pathology; D016217:Ultrasonography, Mammary