Microdochectomy in women aged over 50 years

Burton, Scott; Li, W. Y.; Himpson, R.; Sulieman, Supervisor Abdelmoneim Adam Mohamed; Ball, Adrian

doi:10.1308/003588403321001444

Cited by 7 publications

(7 citation statements)

References 10 publications

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“…Of 20 breast cancer cases, 16 (80%) had bloody discharge. Literature reports malignancy incidences from 63% up to 100% in patients with bloody nipple discharge (15,21,(25)(26)(27). Breast cancer was found in 14% (16 out of 115) of bloody nipple discharge, compared to 6% (4 of 69) with nonbloody discharge.…”

Section: Discussionmentioning

confidence: 99%

Does Nipple Discharge Color Predict (pre‐) Malignant Breast Pathology?

et al. 2016

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Unilateral single-duct nipple discharge is associated with an increased risk for underlying breast malignancy. There is no consensus whether color of nipple discharge independently indicates the risk of malignancy. We sought to assess the relationship between the color of discharge and the risk of malignancy. Patients with unilateral single-duct nipple discharge without abnormalities on clinical and radiologic examination were included. Prior to diagnostic microdochectomy nipple discharge characteristics were registered. Multiple logistic regressions were performed to assess the relationship between color of nipple discharge and malignancy, corrected for age. During a mean follow-up period of 7.1 years we determined complication rate and false-negative rate of microdochectomy. A total of 184 patients were included (median age 53 years, range 19-84). Histologic examination revealed (in situ or invasive) breast carcinoma in 10.9% (20) of patients and high-risk lesions in 11.4% (21). Malignancy or high-risk lesions were found in 25% (OR: 1.37; 95% CI: 0.62-3.00) of patients with bloody discharge. Risk of underlying malignancy increased in patients >60 years (OR: 2.35; 95% CI: 1.14-4.83). Complication rate of microdochectomy was 2.7%. Single-duct, unilateral nipple discharge is a sign of underlying malignancy in a substantial proportion of cases. The majority of patients with unilateral single-duct nipple discharge, diagnosed with breast cancer, present with bloody discharge. However, the association between bloody nipple discharge and malignancy is not strong enough to distinguish high-risk patients. Therefore, invasive diagnostic procedures like microdochectomy should be offered to all patients with unilateral uniductal nipple discharge to search for underlying malignancy.

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Section: Discussionmentioning

confidence: 99%

Does Nipple Discharge Color Predict (pre‐) Malignant Breast Pathology?

et al. 2016

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“…This information confirms the value of the ductoscopy in the pathological discharge evaluation [9]. For this reason, the ductoscopy has been recently included in the spontaneous thelorrhea evaluation [1,5]. However, this technology is not available in all the geographical regions of the world due to the high cost and complexity [10].…”

Section: Discussionmentioning

confidence: 67%

“…This evaluation starts with a rigorous clinical breast exam along with an ultrasound study and, in women over 40, a complementary mammogram. The breast ultrasound could identify endoluminal lesions that suggesting papilloma after which we recommend a pathological study by percutaneous route [1]. Different studies have been used such as discharge cytology, galactography (ductography), discharge carcinoembryonic antigen studies and even galactography with magnetic resonance.…”

Section: Discussionmentioning

confidence: 99%

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Microductectomy: Current Surgical Technique for Pathological Ductal Discharge

2018

IJCRT

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Thelorrhea is one of the most common reasons for consultation in mastology. In the cases of a discharge with a pathological appearance, an appropriate approach is important given the possibility of it originating in a malignant neoplasm. Its study currently includes advanced diagnostic procedures such as ductoscopy with biopsy or brushing. However, these kinds of diagnostic intervention are not available everywhere and therefore, the surgical removal of the affected duct continues to be of great value diagnostically as well as therapeutically, especially in women with unsatisfied parity.

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“…Other potential pre-operative tests such as ductography (galactography) or ductoscopy are not performed in our unit. Ductography was introduced over 60 years ago [ 29 ], but has not become standard practice in many parts of the world [ 6 , 30 , 31 ]. It has not proved to be very effective at discriminating between benign and malignant lesions, and a negative test does not exclude malignancy [ 1 ].…”

Section: Discussionmentioning

confidence: 99%