Preclinical Study

Breast Cancer Research and Treatment

, Volume 118, Issue 1, pp 9-13

First online:

Intraductal approach to the detection of intraductal lesions of the breast

  • Tadaharu MatsunagaAffiliated withDepartment of Breast Diseases, Tokyo Medical University Hachioji Medical Center Email author 
  • , Takeharu MisakaAffiliated withDepartment of Breast Diseases, Tokyo Medical University Hachioji Medical Center
  • , Katsumasa HosokawaAffiliated withDepartment of Breast Diseases, Tokyo Medical University Hachioji Medical Center
  • , Shinichiro TairaAffiliated withDepartment of Breast Diseases, Tokyo Medical University Hachioji Medical Center
  • , Kyeongil KimAffiliated withDepartment of Breast Diseases, Tokyo Medical University Hachioji Medical Center
  • , Hiromi SerizawaAffiliated withDepartment of Pathology, Tokyo Medical University Hachioji Medical Center
  • , Hutoshi AkiyamaAffiliated withDepartment of Pathology, Cancer Institute Hospital
  • , Masahiko FujiiAffiliated withDepartment of Pathology, Kyorin University School of Health Science

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Abstract

Bloody nipple discharge is a clue in the detection of ductal carcinoma of the breast that do not display a mass. Since sensitivity of discharge cytology is not sufficiently high and mammary ductendoscopy (MS) contributes to the diagnosis of intraductal lesions. We set out to determine whether the intraductal approach is effective for detection of ductal carcinoma. We performed 445 MS procedure in 323 patients who had nipple discharge but no overt mass. The diagnostic accuracy rates of discharge cytology and intraductal breast biopsy (IDBB) were studied in detecting malignancy. The therapeutic value of IDBB for intraductal papillomas was studied in 73 patients. Out of 323 patients, 80 had breast cancer and 155 had intraductal papilloma. MS detected intraductal tumors in 47 cases (58.8%). IDBB was performed in 35 of these 47 cases. The sensitivity was 37.1% by touch cytology, 68.6% by IDBB, and 82.8% by directed ductal lavage cytology. Of the 73 intraductal papilloma patients who were followed for more than 3 years, the therapeutic effectiveness of IDBB was recognized in 57 (78.1%). Directed ductal lavage cytology was the most sensitive method in detecting malignancy. MS and IDBB were benefit in the treatment of intraductal papilloma.

Keywords

Breast cancer Nipple discharge Lavage cytology Ductal cancer Intraductal papilloma