General Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey.
Ann Surg Oncol. 2010 Mar;17(3):778-83. doi: 10.1245/s10434-009-0820-y. Epub 2009 Dec 11.
Nipple discharge is a relatively common complaint among patients visiting specialized outpatient clinics for disease of the breast. With advancing technology, it became possible to diagnose and manage nipple discharge using minimally invasive procedures. The aim of this study is to report our experience with ductoscopic evaluation of patients with nipple discharge.
Between September 2005 and February 2009, 236 patients with complaint of nipple discharge were admitted prospectively into the study. All patients were evaluated with ductoscopy. Data concerning age, ductoscopic and postsurgical diagnosis, duration, and complications with the procedure were statistically analyzed.
For 236 patients evaluated, there were 249 ductoscopic investigations. Of these, 39 patients were found to have intraductal solitary papilloma of which 24 were excised ductoscopically. Of the 24 ductoscopically excised solitary papillomas, it was possible to remove 17 completely, but 7 papillomas could be removed partially. For 13 patients with solitary papillomas large enough or unfavorably localized so that they could not be snare-excised and for 14 patients with multiple papillomas, we offered surgical removal of the lesions by limited excision of the ducts with the help of ductoscopic localization and marking. There were 35 patients who had debris within the canalicular system, and the debris was washed out. Ductoscopy revealed atypical ductal hyperplasia in 3 patients, ductal carcinoma in situ in 6 patients, and invasive carcinoma in 3 patients; all patients underwent surgery.
We believe that, as the technology quickly improves, ductoscopy will become more widely accepted and applied for breast disorders, not only as a diagnostic tool but also as a privileged therapeutic option for certain pathologies.
乳头溢液是患者在乳腺专科门诊就诊时较为常见的主诉之一。随着技术的进步，采用微创方法对乳头溢液进行诊断和处理已成为可能。本研究旨在报告我们采用乳管镜检查乳头溢液患者的经验。
2005 年 9 月至 2009 年 2 月，前瞻性地连续纳入了 236 例乳头溢液患者。所有患者均接受了乳管镜检查。对患者的年龄、乳管镜和术后诊断、病程及操作相关并发症等数据进行了统计学分析。
对 236 例患者进行了 249 例次乳管镜检查。其中 39 例发现乳管内单发乳头状瘤，24 例经乳管镜切除。在 24 例经乳管镜切除的单发乳头状瘤中，17 例完全切除，7 例部分切除。对于 13 例单发乳头状瘤体积较大或位置不佳而无法套切者，以及 14 例多发性乳头状瘤患者，我们采用乳管镜定位和标记，在有限切除乳管的基础上进行了病变切除。35 例患者乳管内有碎屑，冲洗后清除。乳管镜发现 3 例患者有非典型性导管增生，6 例患者有导管原位癌，3 例患者有浸润性癌；所有患者均接受了手术治疗。
我们认为，随着技术的快速发展，乳管镜将越来越被广泛接受并应用于乳腺疾病，不仅作为一种诊断工具，而且作为某些病变的首选治疗方法。
