Fiberoptic Ductoscopy of the Breast: A New Diagnostic Procedure for Nipple Discharge
Atsushi OkazakiM. OkazakiKen AsaishiHiroaki SatohYoshihito WatanabeTakashi MikamiKanji TodaYoshimitsu OkazakiKoichi NabetaKoichi Hirata
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Abstract:
A fiberoptic ductoscopy system was successfully developed by means of which we were able to observe the duct cavity of the breast. Two kinds of silicafiberscopes with outer diameters 0.80 and 0.45 mm were used in the present study. Fiberoptic ductoscopy was applied to 52 ducts in 46 patients with nipple discharge for whom no tumor was palpable; the intraductal appearance could be observed in 47 ducts from 41 patients (90.3%). Fourteen ducts from 13 patients were operated upon and were histologically diagnosed as carcinoma (four cases), intraductal papilloma (nine ducts from eight patients) and mastitis (one case). The internal surface of a normal duct was lustrous and smooth. Cancer growing on the surface of a duct wall appeared white and was slightly elevated, forming a bridging structure. The intraductal papillomas formed intraductal solid nodules, being yellow in most cases and red at the site of hemorrhage. Fiberoptic ductoscopy can be used to recognize the growth of minute intraductal lesions in cases of nipple discharge. Clinical endoscopic diagnosis for minute intraductal lesions will make an important contribution to the early detection of cancer and the evaluation of nipple involvement in intraductal carcinoma.Keywords:
Nipple discharge
Intraductal papilloma
Papillomatosis
Objective To analyze the galactographic features in breast diseases with nipple discharge,and to improve the diagnostic accuracy of breast diseases.Methods The manifestations of mammograms,galactograms in breast cancer with nipple discharge were analyzed retrospectively and compared with pathologic findings.Results Two cases were cystic hyperplasia,21 cases were intraductal papilloma,5 cases were intraductal papillomatosis,3 cases were intraductal papilloma with intraductal papillomatosis,2 cases were ductal carcinoma,the misdiagnosis was 2 cases compared with pathologic findings and the accuracy rate of diagnosis was 93.96%.Conclusion Breast galactography plays important roles in diagnosis of breast diseases with nipple discharge.
Nipple discharge
Intraductal papilloma
Papillomatosis
Atypical Hyperplasia
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Objective To investigate the applied value of fiberoptic ductoscopy in the diagnosis and therapy for nipple discharge. Methods From March 2006 to March 2007,the clinical data of 27 cases received fiberoptic ductoscopic examination and lavage were analyzed retrospectively. Results Among the 27 patients, 12 patients were diagnosed as intraductal papilloma by ductoscopy (1 case was as ductal carcinoma in situ),5 patients were diagnosed as papillomatosis. 8 cases were diagnosed as mammary duct ectasis or galactophoritis. No abnormality were found in 2 cases. The diagnostic coincidental rate of the intraductal papilloma and papillomatosis in the ductoscopy and pathology were 91.7% (11 / 12)and 80% (4 / 5)respectively. Conclusion Examination and flush for nipple discharge can be carried out with fiberoptic ductoscopy under direct vision. With high diagnostic accuracy, fiberoptic ductoscopy is reliable for diagnosis and treatment of the nipple discharge.
Nipple discharge
Papillomatosis
Intraductal papilloma
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Objective:To analyze the galactographic features in breast cancer with nipple discharge and intraductal papilloma,and to assess their diagnostic value and differential diagnostic value.Methods:A retrospective study was performed to analyze the galactographic features of 23surgically and pathologically proved breast cancer and intraductal papilloma during September 2006to November 2011.Results:Galactographic features of breast cancer:There were irregular intraductal filling defects with ductal wall destruction and ductal obstruction in the peripheral ducts.Galactographic features of intraductal papilloma:there were smooth intraductal filling defects without wall destruction of the main duct,and ductal dilatation and torsion.Conclusion:The above mentioned differences in galactographic patterns such as location and changes of duct wall and lumen,in breast cancer and intraductal papilloma have their own characteristics which serves as the key to the diagnosis and differential diagnosis.
Intraductal papilloma
Nipple discharge
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Nipple discharge
Papillomatosis
Intraductal papilloma
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Objective To investigate the characteristics,diagnosis and treatment of the intraductal papillomatosis.Methods The clinical data of 65 patients who had been pathologically diagnosed as having intraductal papilloma or intraductal papillomatesis from November 2000 to September 2011 were analyzed retrospectively.Results Among the 65 patients,49(75.4%) had nipple discharge,including light bloody discharge in 32 patients(65.3%) and yellow discharge in 17(34.7%).Sixteen patients(24.6%) were diagnosed with masses of the nipple and areola area.Intraductal papilloma was found pathologically in 56 patients,intraductal papillomatosis in 5,and papillomatosis with malignant transformation in 4.Forty-nine patients with nipple discharge were detected by breast Duct endoscopy,with a detection rate was 85.7%.Conclusions Nipple dischange is the most common symptom in patients with intraductal papilloma.Breast Duct endoscopy is a valuable method for the diagnosis of intraductal papillomas.Carcinoma change may be possible in intraductal papillomatosis.
Papillomatosis
Nipple discharge
Intraductal papilloma
Bloody
Malignant Transformation
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Objective To sum up and analyze the clinical significance of nipple discharge and to introduce its diagnostic methods in order to provide a scientific basis for more rational treatment in clinical practice. Methods Retrospective analyses of 285 cases of nipple discharge who had undergone surgical operations during the period from Jan 1990 to Aug 2002 were made. Results Of the 285 in-patients, 55 had breast cancer (19.3%), 130 had intraductal papilloma (45.6%), 20 had intraductal papillomatosis(7.0%) ,36 had ductal di-lation(11.6%), 11 had inflammation of the mammary duct(3.9%). Among above-mentioned diseases, breast cancer, intraductal papilloma and intraductal papillomatosis predominated, totalling 205 cases (71.9%). Conclusion Intraductal endoscopy was the first choice of etiological diagnosis of nipple discharge. Opportune etiological diagnosis of nipple discharge,especially bloody discharge, should be made for rational surgery.
Nipple discharge
Papillomatosis
Intraductal papilloma
Etiology
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Nipple discharge
Papillomatosis
Ectasia
Endoscope
Intraductal papilloma
Breast disease
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Objective To explore the X-ray characteristic findings of the intraductal papilloma to improve the radiologic diagnostic rate.Methods The mammographic data of 70 cases with intraductal papilloma of breast by pathology were analysed.Results Among 66 patients with nipple discharge 29 cases showed circular filling defect,7 cases showed stringy filling defect,17 cases had irregular filling defect,13 cases had mammary duct blocked ;4 cases with no nipple discharge all showed nodes.Conclusion To recognize the specific X-ray findings of intraductal papilloma of breast is valuable for diagnosis.
Intraductal papilloma
Nipple discharge
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【Objective】To evaluate the applicative value of fiberoptic ductoscopy (FDS) in abnormal nipple dis- charge. 【Methods】 A total of 28 patients with nipple discharge caused by intraductal tumors were examined by fiberoptic ductoscopy to determined the location of lesion, and give them further surgical treatment to confirm their pathological diagnosis. 【Results】Of the 28 cases, early breast cancer were found in 2 cases (7.1%), papilloma in 20 cases (71.4%), papillomatosis in 6 cases (21.4%). 【Conclusions】Intraductal lesion of patients with nipple discharge can be observed by FDS, thus improve the accuracy of diagnosis for the patients with nipple discharge. Breast local- ization needle under the assistance of endoscopy can avoid blindness of operation and help to improve the detection of lesion.
Nipple discharge
Papillomatosis
Intraductal papilloma
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A series of 98 patients with spontaneous nipple discharge, is reported. Diagnosis was based on: clinical examination, cytology of breast secretion, mammography and galactography. Surgical resection was recommended in the following cases: galactographic evidence of intraductal papilloma or papillomatosis, dubious or positive cytology, persisting hemorrhagic or sero-hemorrhagic secretion. The injection of vital staining before the operation allowed the precise location of the lesion. In the group of patients studied ten cases of ductal carcinomas (5 in situ and 5 smaller than 1 cm), 4 cases of atypical intraductal hyperplasia, 13 cases of solitary papilloma and 22 cases of multiple papillomatosis were diagnosed.
Papillomatosis
Intraductal papilloma
Nipple discharge
Atypical Hyperplasia
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