Mammary ductoscopy for diagnosis and treatment of intraductal lesions of the breast

Matsunaga, Tadaharu; Ohta, Daisuke; Misaka, Takeharu; Hosokawa, Katsumasa; Fujii, Masahiko; Nakayama, S.; Kojima, Hiroshi; Kusama, Mikio; Koyanagi, Yasuhisa

doi:10.1007/bf02967511

Cited by 73 publications

(35 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this respect, the ductoscopic visualization done by Dooley [19] reached a depth of 7.5 cm, Kothari et al [20] state a maximum depth of 8.9 cm; in 66% of the cases the visualization reached to a depth of over 2 cm into the mammary duct system. In contrast, in other publications the use of ductoscopy is only considered for the central ducts [21,22]. As regards the endoscopic intraductal findings, we determined a sensitivity of 55.2% and a specificity of 61.5% for ductoscopy.…”

Section: Discussionmentioning

confidence: 78%

Diagnostic Value of Ductoscopy in the Diagnosis of Nipple Discharge and Intraductal Proliferations in Comparison to Standard Methods

Grunwald

Heyer²,

Paepke³

et al. 2007

Oncol Res Treat

View full text Add to dashboard Cite

Ductoscopy is gaining increased importance in the diagnosis of nipple discharge of unclear origin and intraductal proliferation. For this reason we compared its diagnostic value and feasibility to standard diagnostic methods. Material and Methods: Ductoscopy was compared to mammography, galactography, sonography, magnetic resonance imaging (MRI), nipple smear, fine needle aspiration cytology (FNAC), and high-speed core biopsy; feasibility, sensitivity, and specificity were investigated for each method. Results: 71 ductoscopies were evaluated, which were followed up by open biopsies. Here, 3 invasive and 8 ductal carcinomas in situ were found, as well as 3 atypical ductal hyperplasias, 44 papillomas/papillomatoses, and 13 benign findings. Feasibility of ductoscopy was in this series 100%. Duct sonography showed the highest sensitivity (67.3%), followed by MRI (65.2%), galactography (56.3%), ductoscopy (55.2%), and FNAC (51.9%). The highest specificity was shown by FNAC, core biopsy, and galactography (each 100.0%), followed by mammography (92.3%), nipple smear (77.8%), ductoscopy, and duct sonography (each 61.5%); the lowest specificity was displayed by MRI (25.0%). Conclusion: The results confirm that ductoscopy can be performed within the same range of sensitivity and specificity as other techniques. In order to make conclusive statements about ductoscopy, especially in order to precisely define the indications for this method, a prospective multicenter study was initiated.

show abstract

Section: Discussionmentioning

confidence: 78%

Diagnostic Value of Ductoscopy in the Diagnosis of Nipple Discharge and Intraductal Proliferations in Comparison to Standard Methods

Grunwald

Heyer²,

Paepke³

et al. 2007

Oncol Res Treat

View full text Add to dashboard Cite

show abstract

“…Researchers were able to depict the lactiferous ducts up to 2-3.3 cm on average, whereby the greatest peripheral depth was 7.5-10 cm [6,8,11,12]. On the other hand, some authors insist on the use of ductoscopy solely for central ducts [13,14]. …”

Section: Ductoscopic Technique and Indicationsmentioning

confidence: 99%

Comparison of Ductoscopy, Galactography, and Imaging Modalities for the Evaluation of Intraductal Lesions: A Critical Review

Sarıca¹,

Öztürk²,

Demirkurek

et al. 2013

Breast Care

277

View full text Add to dashboard Cite

Background: Today, in cases of nipple discharge of unclear origin, the abundance of diagnostic procedures - a ‚diagnostic dilemma' - becomes apparent, because unequivocal indications and a current, standardized examination sequence are presently not available. The diagnostic workup of patients with nipple discharge usually includes the clinical history, physical examination, mammography, ultrasonography, galactography, and nipple discharge cytology, but not ductoscopy. Methods: In this review we analyze and discuss the possible role of ductoscopy in evaluating intraductal pathologies and its combined use with diagnostic imaging modalities. For this purpose, we reviewed and compared the results of the radiological, pathological, and surgical studies independently. Conclusions: Currently, there is no solitary accurate modality to reach our definitive purpose. Being aware of the capability of each diagnostic modality may take us closer to our target. Therefore, adjunct and appropriate use of multiple imaging modalities and ductoscopy is necessary to evaluate patients with nipple discharge.

show abstract

“…An additional channel of ductoscopes of a U.S. manufacturer of only 0.35 mm [12] can be used for irrigation and ductal lavage but not in conjunction with micro-instruments of 0.4-0.8 mm. However, in Japan intraductal biopsy forceps were developed and have been used for several years [15,16]. In contrast to diagnostic ductoscopes, interventional ductoscopes offer a working channel with an inner diameter of up to 0.8 mm through which multiple newly developed as well as adopted or adjusted micro-instruments from gastrointestinal endoscopy can be used.…”

Section: From Diagnostic To Interventional Ductoscopymentioning

confidence: 99%

Breast Ductoscopy: Technical Development from a Diagnostic to an Interventional Procedure and Its Future Perspective

et al. 2007

View full text Add to dashboard Cite

Background: Endoscopy of the female breast, known as ductoscopy, is increasingly gaining acceptance as a diagnostic procedure worldwide. Recent technical development of ductoscopes and micro-instruments is shifting research interest from diagnostic to interventional ductoscopy. We describe novel technical aspects and the resulting possible future perspective of ductoscopy. Methods: This study comprised the analysis and review of new technical developments from research at the Technical University Munich, Germany, and others, as well as a review of the MEDLINE and COCHRANE databases for the keyword ductoscopy. Results: Diagnostic ductoscopy is performed by many breast physicians worldwide. Interventional ductoscopy, however, depends on an additional working channel and a variety of micro-instruments of 0.4-0.8 mm for procedures inside the breast duct. They are at present not available in the U.S. but are used in Germany and several other countries. Autofluorescence ductoscopy is a new imaging technique used on an experimental base for clinical evaluation to identify intraductal lesions. Laser ductoscopy for removal of intraductal papillomas and 3-dimensional intraductal tracking systems are future projects. Conclusion: Technical innovation and further miniaturization of instruments is supporting a change from diagnostic to interventional ductoscopy. A therapeutic intraductal approach as well as autofluorescence endoscopy could potentially eliminate unnecessary biopsies and offer better identification of intraductal lesions.

show abstract

Mammary ductoscopy for diagnosis and treatment of intraductal lesions of the breast

Abstract: Mammoscopy contributes not only the diagnosis in cases of nipple discharge, but is also of benefit in the treatment of intraductal papilloma.

Cited by 73 publications

References 13 publications

Diagnostic Value of Ductoscopy in the Diagnosis of Nipple Discharge and Intraductal Proliferations in Comparison to Standard Methods

Diagnostic Value of Ductoscopy in the Diagnosis of Nipple Discharge and Intraductal Proliferations in Comparison to Standard Methods

Comparison of Ductoscopy, Galactography, and Imaging Modalities for the Evaluation of Intraductal Lesions: A Critical Review

Breast Ductoscopy: Technical Development from a Diagnostic to an Interventional Procedure and Its Future Perspective

Contact Info

Product

Resources

About