Saarela A O, Kiviniemi H O, Rissanen T J
Department of Surgery, Oulu University Hospital, Finland.
Int Surg. 1997 Oct-Dec;82(4):403-5.
Microdochectomy is the standard treatment of galactographically suspicious breast lesions. Precise preoperative marking of the suspicious duct and intraductal lesions facilitates selective minimal-volume microdochectomy. Methylene blue dye staining fulfills this criterion. A retrospective review of our experience of preoperative methylene blue staining in 30 patients with unilateral spontaneous nonlactiferous single duct nipple discharge operated on during 1986-1995 in the Oulu University Hospital for galactographically suspicious breast lesions. Galactography was successful in 29 out of 30 (93.3%) cases. Preoperative methylene blue staining was attempted in all cases on the day of surgery and it was successful in 22 (73.3%) cases making subsequent selective minimal-volume microdochectomy easy to perform. The failure of methylene blue staining led to quadrantectomy in 4 cases and smaller breast resections in the remaining 4 cases. Preoperative methylene blue dye staining crucially facilitates selective minimal-volume microdochectomy. An interval between primary galactography and later methylene blue staining leads to failures in approximately one quarter of the cases. A higher success rate would necessitate scheduling the microdochectomy on the same day as the primary galactography (and the subsequent methylene blue staining in suspicious cases).
微小乳管切除术是乳腺导管造影显示可疑的乳腺病变的标准治疗方法。对可疑导管及导管内病变进行精确的术前标记有助于实施选择性小体积微小乳管切除术。亚甲蓝染料染色符合这一标准。回顾性分析1986 - 1995年在奥卢大学医院对30例单侧自发性非泌乳性单导管乳头溢液且乳腺导管造影显示可疑乳腺病变的患者进行术前亚甲蓝染色的经验。30例患者中29例（93.3%）乳腺导管造影成功。所有病例均在手术当日尝试进行术前亚甲蓝染色，22例（73.3%）成功，使得随后的选择性小体积微小乳管切除术易于实施。亚甲蓝染色失败导致4例行象限切除术，其余4例行较小范围的乳腺切除术。术前亚甲蓝染料染色对实施选择性小体积微小乳管切除术至关重要。初次乳腺导管造影与随后的亚甲蓝染色之间若有间隔，约四分之一的病例会失败。若要提高成功率，则需将微小乳管切除术安排在与初次乳腺导管造影同一天进行（可疑病例随后进行亚甲蓝染色）。
