Ling Hong, Liu Guang-yu, Lu Jin-song, Love Susan, Zhang Jia-xin, Xu Xiao-li, Xu Wei-ping, Shen Kun-wei, Shen Zhen-zhou, Shao Zhi-min
Department of Surgery, Cancer Hospital, Fudan University, Shanghai, China.
Breast J. 2009 Mar-Apr;15(2):168-75. doi: 10.1111/j.1524-4741.2009.00692.x.
Fiberoptic ductoscopy (FDS)-guided intraductal biopsy is a minimally invasive technique developed to obtain pathologic diagnoses for patients with spontaneous nipple discharge. We performed biopsies of 53 intraductal lesions from March 2006 to April 2007 followed by surgical microdochectomy. FDS-guided intraductal biopsy was shown to be a minimally invasive, safe, and convenient technique with a high ability (90.6%) to get adequate samples. Twenty-seven solitary papillomas, 12 multiple intraductal papilloma, five ductal hyperplasia, three ductal carcinoma in situ, and one invasive ductal carcinoma were diagnosed. Compared with conventional microdochectomy, FDS-guided intraductal biopsy can significantly increase the detection rate of solitary papilloma (40.7% versus 92.6%, p < 0.05). It should be a routine procedure after intraductal lesion found by screening FDS. Since it would underestimate all multiple intraductal papilloma and some (50%) cancer, microdochectomy is inevitable if biopsies show atypical ductal hyperplasia.
纤维乳管镜（FDS）引导下的乳管内活检是一种为有乳头溢液的患者获取病理诊断而开发的微创技术。我们在2006年3月至2007年4月期间对53例乳管内病变进行了活检，随后进行了手术性微小乳管切除术。结果显示，FDS引导下的乳管内活检是一种微创、安全且便捷的技术，获取足够样本的能力较高（90.6%）。诊断出27例孤立性乳头状瘤、12例多发性乳管内乳头状瘤、5例导管增生、3例导管原位癌和1例浸润性导管癌。与传统的微小乳管切除术相比，FDS引导下的乳管内活检可显著提高孤立性乳头状瘤的检出率（40.7%对92.6%，p<0.05）。在通过FDS筛查发现乳管内病变后，它应成为常规操作。由于它会低估所有多发性乳管内乳头状瘤和部分（50%）癌症，如果活检显示非典型导管增生，则不可避免地需要进行微小乳管切除术。
