Does mammary ductoscopy have a role in clinical practice?

Area of Science:

• Oncology
• Surgical Endoscopy
• Diagnostic Imaging

Background:

• Mammary ductoscopy (MD) utilizes microendoscopes for direct visualization of the mammary ductal epithelium.
• The technique allows for insufflation, irrigation, lavage, and potential therapeutic interventions within the ducts.
• MD can be performed in an office setting under local anesthesia.

Purpose of the Study:

• To assess the technical feasibility of mammary ductoscopy.
• To evaluate its role in guiding ductal excision surgery.
• To examine its utility in the early diagnosis of breast malignancy.

Main Methods:

• Mammary ductoscopy performed on 26 patients using a 1 mm fiberoptic microendoscope.
• 13 patients undergoing surgery for ductal carcinoma (DCIS, infiltrating ductal carcinoma).
• 13 patients with pathological nipple discharge (PND) and benign findings, with procedures under local or general anesthesia.

Main Results:

• Intraoperative MD successful in 84.6% of patients undergoing surgery for DCIS.
• Intraductal pathology visualized in 80% of mastectomy cases; cytology sensitivity for malignancy was 16%.
• In PND cases, MD was successful in 90% and well-tolerated; findings included papilloma, duct ectasia, and suspicious lesions.

Conclusions:

• Mammary ductoscopy is technically feasible and shows potential for early breast cancer detection.
• The procedure is safe for office settings and recommended for single-duct PND.
• MD may reduce the need for extensive surgical resection, but improved biopsy tools are needed for malignancy diagnosis.