Abstract
Background. Breast carcinoma and precancer are thought to start in the lining of the milk duct or lobule. While ductography has been advocated as the main procedure in patients with nipple discharge, fiberoptic ductoscopy (FDS) is an emerging technique allowing direct visual access to the ductal system of the breast through nipple orifice exploration.
Methods. We applied ductography and FDS to 65 women who had nipple discharge, and compared their utility.
Results. Intraductal lesions occurred in the segmental duct and the first, second, third, fourth, fifth, and sixth branches in decreasing frequency with ductography and FDS screening. The detection rates of intraductal abnormal lesions by ductography and FDS and the their combination were 89.1 (37 patients), 97.4 (38 patients), and 97.5% (39 patients) respectively. Ductal washings performed during FDS were effective to obtain representative exfoliated ductal cells which could be evaluated (sensitivity 50%, specificity 94.3%, and diagnostic accuracy 89.7%). As a result, we diagnosed 35 cases of benign lesions and four cases of malignant lesions by cytological or/and histological examination.
Conclusion. Ductography and fiberoptic ductoscopy are useful procedure in guiding subsequent breast surgery in the treatment of nipple discharge.
Similar content being viewed by others
References
Paterok EM, Rosenthal H, Sabel M: Nipple discharge and abnormal galactogram. Results of a long-term study (1964-1990). Eur J Obstet Gynecol Reprod Biol. 50: 227-234, 1993
Gulay H, Bora S, Kilicturgay S, Hamaloglu E, Goksel HA: Management of nipple discharge. J Am Coll Surg 178: 471-474, 1994
Rongione AJ, Evans BD, Kling KM, Mcfadden DW: Ductography is a useful technique in evaluation of abnormal nipple discharge. Am Surg 62: 785-788, 1996
Dawes LG, Bowen C, Venta LA, Morrow M: Ductography for nipple discharge: no replacement for ductal excision. Surgery 124: 685-691, 1998
Love SM, Barsky SH: Breast duct endoscopy to study stages of cancerous breast disease. Lancet 348: 997-999, 1996
Okazaki A, Hirata K, Okazaki M, Svane G, Azavedo E: Nipple discharge disorders: current diagnostic management and the role of fiber-ductoscopy. Eur Radiol 9: 583-590, 1999
Shen KW, Wu J, Lu JS, Han QX, Shen ZZ, Nguyen M, Shao ZM, Barsky SH: Fiberoptic ductoscopy for patients with nipple discharge. Cancer 89: 1512-1519, 2000
Sakamoto G, Sugano H, Hartman WH: Comparative pathological study of breast carcinoma among American and Japanese women. In: McGuire WL (ed) Breast Cancer. Advances in Research and Treatment. Vol 4, Plenum Medical Book Co, New York, 1981, pp 211-231
Mori T, Inaji H, Koyama H, Abe R, Nihei M, Izuo M, Ogawa T, Enomoto K, Sato H, Kasumi F: Evaluation of an improved dot-immunobinding assay for carcinoembryonic antigen determination in nipple discharge in early breast cancer: results of a multicenter study. Jpn J Clin Oncol 22: 371-376, 1992
Inaji H, Koyama H, Motomura K, Noguchi S, Mori Y, Kimura Y, Sugano K, Ohkura H: ErbB-2 protein levels in nipple discharge: role in diagnosis of early breast cancer. Tumour Biol 14: 271-278, 1993
Miyazaki M, Tamaki Y, Sakita I, Fujiwara Y, Kadota M, Masuda N, Ooka M, Ohnishi T, Ohue M, Sekimoto M, Tomita N, Furukawa J, Matsuura N, Monden M: Detection of microsatellite alterations in nipple discharge accompanied by breast cancer. Breast Cancer Res Treat 60: 35-41, 2000
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yamamoto, D., Shoji, T., Kawanishi, H. et al. A utility of ductography and fiberoptic ductoscopy for patients with nipple discharge. Breast Cancer Res Treat 70, 103–108 (2001). https://doi.org/10.1023/A:1012990809466
Issue Date:
DOI: https://doi.org/10.1023/A:1012990809466