Denewer Adel, El-Etribi Khalil, Nada Nadia, El-Metwally Mohamed
Department of Surgical Oncology, Oncology Center, Mansoura University, Mansoura, Eqypt.
Breast J. 2008 Sep-Oct;14(5):442-9. doi: 10.1111/j.1524-4741.2008.00620.x. Epub 2008 Jul 30.
Mammary ductoscope allows visualization of the breast ductal wall and sampling of the abnormal area for diagnostic purposes. We are reporting our center experience in application of mammary ductoscope in detecting the underlying etiology of pathologic nipple discharge. Between November 2005 and December 2006 a total of 54 women, with spontaneous persistent nonlactational unilateral uniductal nipple discharge of no palpable lesions and negative breast sono-mammography, were included in the study for morphologic assessment of ductal epithelium, ductal lavage and ductoscopically guided procedures as punch biopsy and ductoscopically guided microdochectomy. Forty-one patients (76%) with nipple discharge were positive ductoscopically. Thirteen patients (24%) appeared normal. Ductoscopic lavage has a much more cellular yield than ordinary squeezing cytology. Ductal thickening by the ductoscope (11 cases) revealed to be hyperplasia on pathology (five cases), papilloma (two cases), atypical ductal hyperplasia (two cases), ductal carcinoma in situ (one case), and invasive breast carcinoma (one case). There was a significant association between intraductal visual observations and histopathologic diagnosis. Mammary Ductoscope is a promising tool in management of pathologic nipple discharge. Biopsy and ablation techniques can be performed during ductoscopy with correlation between visual findings and histopathology, but there are still some limitations of in clinical practice.
乳腺导管镜可用于观察乳腺导管壁，并对异常区域进行取样以用于诊断目的。我们报告了我们中心应用乳腺导管镜检测病理性乳头溢液潜在病因的经验。在2005年11月至2006年12月期间，共有54名女性纳入本研究，她们均有自发性持续性非哺乳期单侧单导管乳头溢液，乳房触诊无明显病变，乳腺超声钼靶检查结果为阴性，对其进行导管上皮形态学评估、导管灌洗以及导管镜引导下的操作，如打孔活检和导管镜引导下的微小乳管切除术。41例（76%）乳头溢液患者导管镜检查呈阳性。13例（24%）表现正常。导管镜灌洗获得的细胞数量比普通挤压细胞学检查多得多。导管镜检查发现导管增厚的11例患者，病理检查显示为增生（5例）、乳头状瘤（2例）、非典型导管增生（2例）、导管原位癌（例）和浸润性乳腺癌（1例）。导管内视觉观察结果与组织病理学诊断之间存在显著相关性。乳腺导管镜是处理病理性乳头溢液的一种有前景的工具。在导管镜检查过程中可进行活检和切除技术，视觉观察结果与组织病理学之间存在相关性，但在临床实践中仍存在一些局限性。
