Abstract:BackgroundTo investigate the diagnostic reliability of selective microdochectomy after direct ductoscopic wire marking of suspect lesions in patients with pathological nipple discharge.MethodsSelective microdochectomy due to pathological discharge was performed in 33 patients with mean age of 51.7 years. Ductoscopes of 0.9 and 1.1 mm in diameter with a channel for wire marking were used. Only patients without sonographic or mammographic correlation for the discharge were included. The pathologic mammary duct w… Show more
“…The low number of cases in the analysis of combinations has to be taken into account. A retrospective multicenter study launched in 2006 addresses the diagnostic value and therapeutic role of ductoscopy in comparison to conventional tests [35,36]. We envision a future with precisely defined indications for ductoscopy and less frequent open biopsies.…”
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.
“…The low number of cases in the analysis of combinations has to be taken into account. A retrospective multicenter study launched in 2006 addresses the diagnostic value and therapeutic role of ductoscopy in comparison to conventional tests [35,36]. We envision a future with precisely defined indications for ductoscopy and less frequent open biopsies.…”
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.
“…The available limited number of publications indicates that the probability of a carcinoma is 0-5% in PND cases that are clinically and radiologically negative [35,67]. Concerning the appropriate diagnostic and treatment approach, the uncertainty remains for which cases MG and US do not report any pathological lesions; however, in this special patient group, surgery and close follow-up options could be combined in existing algorithms [4,35]. …”
Section: Sensitivity and Specificitymentioning
confidence: 99%
“…With the efforts of researchers in the early 1990s, direct endoluminal visualization of the breast ducts has become possible [3]. In contrast to the initial rigid ductoscopes with a diameter of more than 1.5 mm, rapidly developing technology has given us the opportunity to use fiberoptic ductoscopes with smaller diameters (0.55-1.1 mm) [4]. …”
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.
“…В свою очередь, M. Hahn и соавт. на примере 33 исследований убедились, что точность эндоско-пической чреспротоковой маркировки ВПНО с по-мощью проволоки составляет 78,3%, а причинами неудач считают либо ложноположительную оценку выявленных изменений эндоскопистом, либо поте-рю патологического субстрата патогистологом [27].…”
Section: обзорыunclassified
“…При отсутствии или исчезновении данного признака и наличии множе-ственных разветвлений рекомендуют продвигаться по протоку большего диаметра, хотя M. Hahn и со-авт. в таких ситуациях прибегают к осмотру всех по-следующих протоков [27]. Если необходима ревизия нескольких протоковых ответвлений, отверстия уже осмотренных галактофоров маркируют красителя-ми или обозначают их на предварительно подготов-ленной картограмме [2,22].…”
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