A novel duct-lobular segmentectomy for breast tumors with nipple discharge using near-infrared indocyanine green fluorescence imaging.
A 44-year-old woman was referred to our hospital with pathological nipple discharge from her left breast. Ultrasonography revealed a solid tumor beneath her left areola that measured 17 mm in diameter with a dilated mammary duct. Contrast-enhanced magnetic resonance imaging showed an early-enhanced cystic tumor and a dilated mammary duct. We performed a duct-lobular segmentectomy using near-infrared indocyanine green (ICG)-fluorescence imaging. Under general anesthesia, a silicone tube was inserted into an orifice of a fluid-discharging mammary duct, and 1 mL dye-fluorescence liquid containing ICG and indigo carmine was injected into the mammary duct. A periareolar incision was made, and the fluorescence image of the demarcated mammary duct segment was obtained. The mammary duct segment was dissected, along with the demarcation line. The cystic lesion and dilated mammary duct were fully resected, and the pathological diagnosis was intraductal papilloma of the breast. We report that near-infrared ICG fluorescence could be applied for imaging of the mammary duct segment, and the fluorescence image allowed for easier duct-lobular segmentectomy for nipple discharge.
Department of Surgery, Nagasaki Municipal Hospital, Nagasaki, Japan. Electronic address: tysoono@nifty.com.
Tsuyoshi
T
Ohno
Keiji
K
Inoue
Shigeki
S
Nagayoshi
Toshio
T
Fukuda
Junji
J
Irie
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D004108:Dilatation, Pathologic; D005260:Female; D005456:Fluorescent Dyes; D006801:Humans; D007208:Indocyanine Green; D042361:Mammary Glands, Human / Q000473:pathology / Q000601:surgery; D015412:Mastectomy, Segmental / Q000379:methods; D055966:Nipple Aspirate Fluid; D009558:Nipples / Q000378:metabolism* / Q000473:pathology; D061848:Optical Imaging; D018300:Papilloma, Intraductal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D019265:Spectroscopy, Near-Infrared / Q000379:methods; D016217:Ultrasonography, Mammary
D005456:Fluorescent Dyes; D007208:Indocyanine Green
breast cancer; duct-lobular segmentectomy; fluorescence imaging; indocyanine green; microdochectomy; nipple discharge