title: The significance of ductoscopy of mammary ducts in the diagnostics of breast neoplasms.
abstract: BACKGROUND
  Ductoscopy is a low invasive method enabling the diagnostics of intraductal proliferative lesions in breasts. Fiberoptic ductoscopy (FDS) is important in the diagnosis of patients with pathological nipple discharge. There are attempts to apply FDS in patients with breast cancer without the presence of nipple discharge.
  
  
  OBJECTIVE
  To assess fiberoptic ductoscopy in the diagnostics of breast neoplasms.
  
  
  METHODS
  The material was composed of a group of 164 patients treated for intraductal proliferative lesions in breasts. In the analyzed group of patients, FDS was conducted in 128 patients with pathological nipple discharge and 36 patients with the presence of breast cancer. The analyzed period was divided into three sub-periods. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FDS examination verified by post-operative histopathological examination were analyzed. The safety of the method was also assessed, taking into consideration the complications.
  
  
  RESULTS
  An increasing number of successful ductoscopies together with the number of performed FDS examinations was noted. There were statistically significant differences in the percentage of successful cannulations in relation to the number of performed FDS examinations in the three subsequent stages of the project (p = 0.011). The duration of FDS examination in the third period was reduced in comparison with the first and second period (p < 0.001). Sensitivity of fiberoptic ductoscopy is 68.1%, specificity 77.3% and PPV 90.4%, but NPV is 44.1%.
  
  
  CONCLUSIONS
  The introduction of fiberoptic ductoscopy in our clinic has contributed to the widening of the diagnostic possibilities of small intraductal lesions of the mammary gland.
authors.affiliation: Department of Surgical Oncology, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Zielinski
authors.affiliation: Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Pomeranian Centre of Traumatology, Gdansk, Poland.
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Jaworski
authors.affiliation: Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Ninela
authors.initials: N
authors.lastname: Irga-Jaworska
authors.affiliation: Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Pomeranian Centre of Traumatology, Gdansk, Poland.
authors.forename: Ireneusz
authors.initials: I
authors.lastname: Haponiuk
authors.affiliation: Department of Surgical Oncology, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Jaskiewicz
keywords: diagnostic method of the breast; fiberoptic ductoscopy; pathologic nipple discharge