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Ex vivo feasibility study of endoscopic intraductal laser ablation of the breast
Author(s) -
de Boorder Tjeerd,
Waaijer Laurien,
van Diest Paul J.,
Witkamp Arjen J.
Publication year - 2018
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.22745
Subject(s) - medicine , ablation , laser , laser ablation , endoscopy , radiology , surgery , optics , physics
Objective To determine the feasibility and safety of breast endoscopic thulium laser ablation for treatment of intraductal neoplasia. Study Design Ductoscopy is a minimally invasive endoscopic approach of the milk ducts of the breast via the nipple. Besides diagnosis in women with pathologic nipple discharge (PND), it allows non‐invasive removal of intraductal lesions with a stalk like papillomas. Removal, however, is often incomplete and flat lesions cannot be targeted. We therefore developed laser ductoscopy. Methods Dosimetry of laser ductoscopy was assessed in thirteen mastectomy specimens, applying power settings of 1–5 W with 100–1000 ms pulsed exposure to a 375‐μm outer diameter thulium fiber laser. Subsequently histology was obtained from the breast tissue that was treated with the Thulium laser. Results Endoscopic view was maintained during ductoscopic laser ablation at 1–3 W. Increasing power to 4–5 W caused impaired vision due to shrinkage of the main duct around the ductoscope tip. Histology revealed localized ablation of the duct wall. Conclusion We show for the first time that laser ductoscopy is technically feasible. The Thulium laser enables a superficial intraductal ablation and is a useful tool for intraductal interventions. An in vivo prospective study is needed to further demonstrate its potential. Lasers Surg. Med. 50:137–142, 2018. © 2017 Wiley Periodicals, Inc.