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Annals of Surgical Oncology

, Volume 20, Issue 10, pp 3352–3354 | Cite as

Interventional Ductoscopy for Pathological Nipple Discharge

  • Fatih Levent BalciEmail author
  • Sheldon Marc Feldman
Breast Oncology

Abstract

Background

Despite the low likelihood of malignancy, it is recommended that patients who have pathologic nipple discharge (PND) undergo duct excision. Intraductal papilloma is well-known most frequent cause of PND. Our goal is to determine whether the ductoscopic retrieval of a solitary papilloma is feasible and/or therapeutic for patients with PND. The accompanying video demonstrates this interventional ductoscopic approach.

Methods

Consented patients who had been diagnosed with PND were recruited to have ductoscopic exploration. Patients with palpable masses and suspicion of malignancy on ultrasound or mammography were excluded. Under local anesthesia, ductoscopy was performed using LaDuScope-T flex with an outer diameter of 1.1 mm, which allows extraction of a single papilloma with a microbasket (380 μm) via a working channel. Patients with sessile single papilloma or failure on ductoscopic extraction underwent ductoscopically guided microductectomy. Success was determined by recurrence of PND and by standard radiological examinations.

Results

Three patients presented in the video had negative cytology and normal conventional diagnostic imaging. Two patients diagnosed with a nonsessile single papilloma underwent successful ductoscopic extraction. The interventional examination times of those patients were 30 and 35 min. Patient who had a sessile papilloma underwent ductoscopically guided microductectomy. These patients had no recurrence of discharge or suspicious of malignancy after 5 years follow-up.

Conclusions

Interventional ductoscopy provides an incisionless therapeutic option for patients diagnosed with a papillary nonsessile benign lesion that causes PND.

Keywords

Papilloma Nipple Polypoid Lesion Nipple Discharge Ductal Lavage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Supplementary material (MP4 36898 kb)

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  1. 1.Division of Breast SurgeryColumbia University College of Physicians and SurgeonsNew YorkUSA

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