Nipple Discharge: Role of Ductoscopy in Comparison with Standard Diagnostic Tests

Abstract

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.

Ductoscopic Detection of Intraductal Lesions in Cases of Pathologic Nipple Discharge in Comparison with Standard Diagnostics: The German Multicenter Study

“…The literature reports sensitivities ranging from 60 to 77% corresponding with specificities between 25 and 66.7% [10,23,25]. Differences between our results and those reported in previous studies can be explained by variations in image interpretation.…”

“…In their study on 71 patients, Grunwald et al [10] reported a sensitivity of 37.9% and a specificity of 92.3%. In their retrospective study, Albrecht et al [23] calculated a sensitivity of 9% and a specificity of 100%, explaining the low sensitivity with a large number of false-negative results.…”

“…Other researches show sensitivities between 26 and 67.3% and specificities of 61.5 and 97% [10,21,22,23]. Due to fluid surrounding intraductal processes, ultrasonography of the ducts is very sensitive in uncovering such lesions.…”

“…It achieved a sensitivity of 81.3% and a specificity of 44.4% in our study. The respective figures in the literature vary: Reported sensitivities are in the range of 50-94%, specificities in the range of 41-66.7% [10,22,23,28,29]. …”

Endoscopic mammoductoscopy: current status and future development

“…Показания к ЭМДС чаще всего возникают при наличии патологических выделений из сосков, хотя имеются единичные публикации о применении эн-доскопии и в случаях кист МЖ [17,23].…”