TY - JOUR
T1 - Interventional ductoscopy for pathological nipple discharge
AU - Balci, Fatih Levent
AU - Feldman, Sheldon Marc
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/10
Y1 - 2013/10
N2 - 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.
AB - 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.
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U2 - 10.1245/s10434-013-3181-5
DO - 10.1245/s10434-013-3181-5
M3 - Article
C2 - 23975311
AN - SCOPUS:84883766158
SN - 1068-9265
VL - 20
SP - 3352
EP - 3354
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 10
ER -