Mammary ductoscopy for the evaluation of nipple discharge and comparison with standard diagnostic techniques

被引:19
作者
Grunwald, Susanne
Bojahr, Bernd
Schwesinger, Gunther
Schimming, Annette
Kohler, Gunter
Schutz, Karen
Ohlinger, Ralf
机构
[1] Ernst Moritz Arndt Univ Greifswald, Dept Gynecol & Obstet, D-17489 Greifswald, Germany
[2] Evangel Hosp Hubertus, Clin Minimally Invas Surg, Berlin, Germany
[3] Ernst Moritz Arndt Univ Greifswald, Inst Pathol, Greifswald, Germany
[4] Ernst Moritz Arndt Univ Greifswald, Inst Diagnost Radiol & Neuroradiol, Greifswald, Germany
关键词
nipple discharge; milk-duct endoscopy; ductoscopy; galactoscopy; breast cancer;
D O I
10.1016/j.jmig.2006.05.004
中图分类号
R71 [妇产科学];
学科分类号
100211 [妇产科学];
摘要
STUDY OBJECTIVE: To describe performance of breast duct endoscopy and compare the method with conventional diagnostic techniques. DESIGN: Canadian Task Force classification III. SETTING: Interdisciplinary Breast Unit of a university hospital. PATIENTS: Consecutive and unselected series of 15 female patients including 20 breasts with nipple discharge. INTERVENTIONS: Prospective data assessment on all patients with ductoscopy for nipple discharge between April 2003 to April 2004. All preoperative (mammography, ultrasonography, nipple smear) and minimally invasive (galactography, fine needle aspiration cytologic study) diagnostics were evaluated and compared with ductoscopy. MEASUREMENTS AND MAIN RESULTS: Mammography on 20 breasts showed BI-RADS-I (5%) BI-RADS-II (50%), and BI-RADS-III (45%). Breast ultrasound scanning showed abnormalities, classified as BI-RADS-III equivalent lesions in all cases. Nipple smear showed in 69.2% a normal cytology and in most cases revealed a papilloma later (n = 8/9). Unilateral galactography was performed in 46.7% who had spontaneous nipple discharge. Two galactography results were unremarkable, and open biopsy demonstrated 1 atypical ductal hyperplasia and papilloma. On 20 breasts of 15 women, 19 ductoscopies were successfully performed (95%). In 17 cases open biopsy followed ductoscopy, and 1 ductal carcinoma in situ (DCIS), 3 atypical ductal hyperplasia (ADH), 1 ductal hyperplasia without atypias, and 12 ductal papillomas were found. CONCLUSION: Compared to nipple smear, the diagnostic value of ductoscopy in this study is superior but marginally inferior to galactography and highly specialized breast ultrasound scanning. Therefore ductoscopy needs to be evaluated on a larger scale, preferably in multicenter trials to further determine its potential and indications. (C) 2006 AAGL. All rights reserved.
引用
收藏
页码:418 / 423
页数:6
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