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Fiberoptic ductoscopy combined with cytology testing in the patients of spontaneous nipple discharge

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Abstract

Fiberoptic ductoscopy system (FDS) offers a safe alternative to ductography in diagnosing intraductal lesions and serves as a guide for subsequent surgery in women with nipple discharge. In this article, we reported the outcomes of FDS combined with cytology testing for diagnosis of spontaneous nipple discharge. From 1997 to 2005, 1,048 women (1,093 breasts total) in the outpatient department underwent successful diagnostic FDS. Discharge was unilateral (86.8%), single ductal (93.4%), and serous (57.9%) or bloody (36.0%). Among 437 (40.0%) of the FDS-positive breasts, we revealed 49 (11.2%) breast carcinomas, 228 (52.2%) central papillomas, and 5 (1.1%) cases of atypical ductal hyperplasia. Ten patients with positive cytology testing received microdochectomy in spite of having a negative FDS, which revealed two additional ductal carcinomas in situ (DCIS), and four papillomas. About 489 breasts were negative for both FDS and cytology testing and were subjected to follow up. About 77 (15.7%) of the breasts underwent tissue diagnosis within a median follow-up time span of 19 months, and one DCIS was detected. The sensitivity of FDS for detection of malignant lesions was 94.2% and increased to 98.1% when combined with cytology testing. Nevertheless, it was less sensitive (p < 0.01) if we used cytology testing only (58.3%), mammography (48.6%), high-frequency sonography (36.4%), or combination of mammography and sonography (56.8%) to detect these malignant lesions. These data confirmed the value of FDS combined with cytology testing as a diagnostic procedure in women with nipple discharge.

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References

  1. Okazaki A, Hirata K, Okazaki M, Svane G, Azavedo E (1999) Nipple discharge disorders: current diagnostic management and the role of fiber-ductoscopy. Eur Radiol 9:583–590

    Article  PubMed  CAS  Google Scholar 

  2. Shen KW, Wu J, Lu JS, Han QX, Shen ZZ, Nguyen M, Shao ZM, Barsky SH (2000) Fiberoptic ductoscopy for patients with nipple discharge. Cancer 89(7):1512–1519

    Article  PubMed  CAS  Google Scholar 

  3. Shen KW, Wu J, Lu JS, Han QX, Shen ZZ, Nguyen M, Barsky SH, Shao ZM (2001) Fiberoptic ductoscopy for breast cancer patients with nipple discharge. Surg Endosc 15(11):134

    Article  Google Scholar 

  4. Pathology and Genetics of Tumours of the Breast and Female Genital Organs (WHO/IARC Classification of Tumours) (2003) In: Tavassoli FA, Devilee P. IARC Press-WHO, Lyon, France

  5. Urban JA, Egeli RA (1978) Non-lactational nipple discharge. CA 28:130–140

    Article  PubMed  CAS  Google Scholar 

  6. Chaudary MA, Millis RR, Davis GC, Hayward JL (1982) Nipple discharge: the diagnostic value of testing for occult blood. Ann Surg 196:651–655

    Article  PubMed  CAS  Google Scholar 

  7. Dillon MF, Mohd Nazri SR, Nasir S, Mc Dermott EW, Evoy D, Crotty TB, O’higgins N, Hill AD (2006) The role of major duct excision and microdochectomy in the detection of breast carcinoma. BMC Cancer 23; 6(1):164

    Google Scholar 

  8. Bauer R, Eckhert K, Nemoto T (1998) Ductal carcinoma in situ associated nipple discharge: a clinical marker for local extensive disease. Ann Surg Oncol 5:452–455

    Article  PubMed  CAS  Google Scholar 

  9. Florio MG, Manganaro T, Pollicino A, Scarfo P, Micali B (1999) Surgical approach to nipple discharge: a ten-year experience. J Surg Oncol 71:235–238

    Article  PubMed  CAS  Google Scholar 

  10. Ishikawa T, Momiyama N, Hamaguchi Y, Takeuchi M, Iwasawa T, Yoshida T, Shimada H (2004) Evaluation of dynamic studies of MR mammography for the diagnosis of intraductal lesions with nipple discharge. Breast Cancer 11(3):288–294

    Article  PubMed  Google Scholar 

  11. Shao ZM, Liu YH, Nguyen M (2001) The role of the breast ductal system in the diagnosis of cancer. Oncol Rep 8(1):153–156

    PubMed  CAS  Google Scholar 

  12. Al Sarakbi W, Worku D, Escobar P, Mokbel K (2006) Breast papillomas: current management with a focus on a new diagnostic and therapeutic modality. Int Semin Surg Oncol 3:1

    Article  PubMed  CAS  Google Scholar 

  13. Makita M, Sakamoto G, Akiyama F, Namba K, Sugano H, Kasumi F, Nishi M, Ikenaga M (1991) Duct endoscopy and endoscopic biopsy in the evaluation of nipple discharge. Breast Cancer Res Treat 18:179–188

    Article  PubMed  CAS  Google Scholar 

  14. Al Sarakbi W, Salhab M, Mokbel K (2006) Does mammary ductoscopy have a role in clinical practice?. Int Semin Surg Oncol 3:16

    Article  PubMed  CAS  Google Scholar 

  15. Mokbel K, Escobar PF, Matsunaga T (2005) Mammary ductoscopy: current status and future prospects. Eur J Surg Oncol 31(1):3–8

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This research was supported in part by the Outstanding Young Investigator Award of National Natural Science Foundation of China (30025015), National Key Project of China (2001BA703BO5), National Natural Science Foundation of China (30371580), the Grant from Shanghai Science and Technology Committee (03J14019), and Outstanding Young Doctors’ Training Project from Bureau of Health, Shanghai (2005).

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Authors and Affiliations

  1. Department of Breast Surgery, Cancer Hospital/Cancer Institute, Fudan University, 399 Ling-Ling Road, Shanghai, 200032, People’s Republic of China

    Guang-Yu Liu, Jing-Song Lu, Kun-Wei Shen, Jiong Wu, Can-Ming Chen, Zhen Hu, Zhen-Zhou Shen & Zhi-Min Shao

  2. Department of Pathology, Cancer Hospital, Fudan University, Shanghai, People’s Republic of China

    Ting-Qiu Zhang

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  1. Guang-Yu Liu
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  2. Jing-Song Lu
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  3. Kun-Wei Shen
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  4. Jiong Wu
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  5. Can-Ming Chen
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  6. Zhen Hu
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  7. Zhen-Zhou Shen
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  8. Ting-Qiu Zhang
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  9. Zhi-Min Shao
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Correspondence to Zhi-Min Shao.

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G-Y Liu and J-S Lu contributed equally to this work.

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Liu, GY., Lu, JS., Shen, KW. et al. Fiberoptic ductoscopy combined with cytology testing in the patients of spontaneous nipple discharge. Breast Cancer Res Treat 108, 271–277 (2008). https://doi.org/10.1007/s10549-007-9598-4

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  • DOI: https://doi.org/10.1007/s10549-007-9598-4

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