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Mammary ductoscopy and follow‐up avoid unnecessary duct excision in patients with pathologic nipple discharge
Author(s) -
Liu Miao,
Guo Giagia,
Xie Fei,
Wang Siyuan,
Yang Houpu,
Wang Shu
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23972
Subject(s) - medicine , nipple discharge , papillomatosis , papilloma , surgery , ectasia , intraductal papilloma , endoscopy , cancer , dermatology , breast cancer , mammography , pathology
Background and Objectives The goal of this study was to evaluate the efficacy of ductoscopy and follow‐up for the diagnoses of intraductal lesions and the concomitant advantages of avoiding surgery for patients with pathologic nipple discharge (PND). Methods Two hundred and sixty‐six ductoscopies were performed for 238 women. Patients with positive ductoscopies underwent surgery. If no positive lesions were present upon ductoscopy, the women were followed. Results Of 266 ductoscopic examinations, 168 (63.2%, 168/266) breasts from 165 patients were found to have positive images. The final histopathological results revealed that 93 patients with intraductal papilloma, 42 with intraductal papillomatosis, 15 with ADH lesions, DCIS in 9 patients, 1 case with invasive ductal carcinoma (IDC), 6 cases with duct ectasia, and 2 cases with inflammation. Seventy‐three patients with negative results upon ductoscopy were followed with a median time of 48 months. Twelve patients had PND recurrence and were diagnosed as papilloma or papillomatosis based on pathology after surgery. PND disappeared for 51 patients after ductoscopy, and no recurrence or disease evolvement was founded for them. Conclusion Ductoscopy and follow‐up were advantageous for selecting patients to undergo surgery or surveillance. The recurrence of PND after ductoscopy might be a strong predictor for having intraductal disease. J. Surg. Oncol. 2015 111:139–143 . © 2015 Wiley Periodicals, Inc.