Endoscopy has revolutionized many aspects of medical care by allowing visual access through natural orifices or surgical minimal access to body cavities. The advent in the 1980s of improved optics allowed the development by the early 1990s of our first submillimeter endoscopes. Japanese breast surgeons faced at that time rapid increases of rates of breast cancer in young women. Because these were premenopausal women with dense small breasts lacking the fat distribution of Western women, mammographic identification and diagnosis was much more difficult than in the U.S. or Europe. More of these women presented with pathologic nipple discharge and Japanese surgeons such as Okazaki and others saw a potential use for these new endoscopes in the identification of nonpalpable, non-mammographically visible cancerous and precancerous lesions. With very limited optics and air insufflation of the ducts, they were able to navigate the first few centimeters of the ductal system and progressively identify more and more causes for the pathologic nipple discharge. Nipple ductoscopy offers a unique approach to visualizing certain forms of breast pathophysiology and could provide a new approach for biopsy and or treatment of various breast abnormalities in the future.
KeywordsEurope Estrogen Tamoxifen Polypropylene Arena
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