Background: This study aims to assess the role of ductoscopy for detecting intraductal anomalies in patients with nipple discharge in comparison to conventional tests and to find an effective combination of both approaches. Materials and Methods: Prior to duct excision, ductoscopy was performed in 97 women. Histologic and all other diagnostic results were compared. Sensitivity, specificity, and efficiency were calculated for all methods. These parameters were also calculated for all possible test combinations in 12 patients who had completed all tests. Results: Breast sonography reached the highest sensitivity (64.1%) and efficiency (64%); mammography had the highest specificity (100%). The sensitivity of ductoscopy was 53.2%, its specificity 60%, and its efficiency 55.1%. Among combinations of all methods, the combination ductoscopy + galactography was the most sensitive (80%). Mammography, magnetic resonance imaging, and ductoscopy were each 100% specific. Ductoscopy was the most efficient (75%) single method. Conclusion: Ductoscopy is a valuable test for diagnosing intraductal lesions in patients with nipple discharge. It is more efficient than conventional tests in patients undergoing all tests.

Recent evidence suggests that the processing of observed actions may reflect an action prediction error, with more pronounced mediofrontal negative event-related potentials (ERPs) for unexpected actions. This evidence comes from an application of a false-belief task, where unexpected correct responses elicited high ERP amplitudes. An alternative interpretation is that the ERP component reflects vicarious error processing, as objectively correct responses were errors from the observed person’s perspective. In this study, we aimed to disentangle the two possibilities by adding the factor task difficulty, which varied expectations without affecting the definition of (vicarious) errors, and to explore the role of empathy in action observation. We found that the relationship between empathy and event-related potentials (ERPs) mirrored the relationship between empathy and behavioral expectancy measures. Only in the easy task condition did higher empathy lead to stronger expectancy of correct responses in the true-belief and of errors in the false-belief condition. A compatible pattern was found for an early ERP component (150–200 ms) after the observed response, with a larger negativity for error than correct responses in the true-belief and the reverse pattern in the false-belief condition, but only in highly empathic participants. We conclude that empathy facilitates the formation of expectations regarding the actions of others. These expectations then modulate the processing of observed actions, as indicated by the ERPs in the present study.

The term “Pavlovian” bias describes the phenomenon that learning to execute a response to obtain a reward or to inhibit a response to avoid punishment is much easier than learning the reverse. The present study investigated the interplay between this learning bias and individual levels of social anxiety. Since avoidance behavior is a hallmark feature of social anxiety and high levels of social anxiety have been associated with better learning from negative feedback, it is conceivable that the Pavlovian bias is altered in individuals with high social anxiety, with a strong tendency to avoid negative feedback, especially (but not only) in a nogo context. In addition, learning may be modulated by the individual propensity to learn from positive or negative feedback, which can be assessed as a trait-like feature. A sample of 84 healthy university students completed an orthogonalized go/nogo task that decoupled action type (go/nogo) and outcome valence (win/avoid) and a probabilistic selection task based upon which the individual propensity to learn from positive and negative feedback was determined. Self-reported social anxiety and learning propensity were used as predictors in linear mixed-effect model analysis of performance accuracy in the go/nogo task. Results revealed that high socially anxious subjects with a propensity to learn better from negative feedback showed particularly pronounced learning for nogo to avoid while lacking significant learning for nogo to win as well as go to avoid. This result pattern suggests that high levels of social anxiety in concert with negative learning propensity hamper the overcoming of Pavlovian bias in a win context while facilitating response inhibition in an avoidance context. The present data confirm the robust Pavlovian bias in feedback-based learning and add to a growing body of evidence for modulation of feedback learning by individual factors, such as personality traits. Specifically, results show that social anxiety is associated with altered Pavlovian bias, and might suggest that this effect could be driven by altered basal ganglia function primarily affecting the nogo pathway.

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Error processing in the human brain has been studied extensively in the past 30 years. Functional magnetic resonance imaging (fMRI) studies as well as studies using electroencephalography (EEG) and source analysis have proposed a close link between error commission and activity in the posterior medial frontal cortex (pMFC; Ullsperger et al., 2014) and anterior cingulate cortex (ACC; Dehaene et al., 1994;Holroyd et al., 2004;Ullsperger & Cramon, 2004; for reviews, see Ridderinkhof et al., 2004;Taylor et al., 2007). Frontocentral activity seems to be reflected in a specific event-related potential (ERP) component (Dehaene et al., 1994;Ridderinkhof et al., 2004), characterized by a negative peak around