Improving ductoscopy with duct lavage and duct brushing

Area of Science:

• Oncology
• Cytopathology
• Breast Surgery

Background:

• Pathological nipple discharge (PND) requires accurate diagnostic methods.
• Ductoscopy allows direct visualization of the mammary ducts.

Purpose of the Study:

• To evaluate the diagnostic accuracy of combined duct lavage (DL) and duct brushing (DB) during ductoscopy for PND.
• To compare the efficacy of combined DL and DB with histology.

Main Methods:

• Sixty-four women with PND underwent ductoscopy with simultaneous DL and DB.
• Cell samples from DL and DB were analyzed using liquid cytology.
• Cytology results were compared against final histological diagnoses.

Main Results:

• The combined technique (CDLDB) achieved an overall accuracy of 71.9% in diagnosing PND.
• Accuracy varied by condition: 89.5% for duct ectasia, 67.9% for papillomas, and 83.3% for breast cancer.
• CDLDB sensitivity ranged from 67% to 90% depending on the specific histological diagnosis.

Conclusions:

• The combined DL and DB technique demonstrates high diagnostic accuracy for PND.
• This combined approach is more accurate than using DL alone for evaluating nipple discharge.