Mammary ductoscopy is useful as a direct and accurate method of characterizing intraductal lesions

 

Mammary ductoscopy is useful as a direct and accurate method of characterizing intraductal lesions. We previously conducted intraductal biopsies to obtain small tissue samples from intraductal lesions for histologic diagnosis and demonstrated that benign lesions may be diagnosed noninvasively using mammary ductoscopy-guided intraductal biopsy and that, in cases of malignant tumors, intraductal cancer spreading toward the nipple can be evaluated preoperatively by mammary ductoscopy. Thus preoperative characterization of intraductal lesions through mammary ductoscopy may be useful for determining when breast-conserving surgery (BCS) can be utilized or when surgery is not indicated. Endoscopic classifications of lesion growth patterns include the polypoid-solitary type, the polypoid-multiple type, the combined type, and the superficial type. Such classification is useful for the diagnosis of intraductal lesions and management of nipple discharge. While the number of lesions is a very important consideration for endoscopic classification and histologic diagnosis, the number of lesions cannot be determined if a lesion obstructs the ductal lumen. In the circumstances, morphology seems to represent a useful parameter for the noninvasive endoscopic differentiation of benign versus malignant intraductal lesions as indicated in our paper.

 

Bibliographic reference: 

Makita M et al.: "Endoscopic and Histologic Findings of Intraductal Lesions Presenting with Nipple Discharge", Breast J. 2006 Sep-Oct;12(5 Suppl 2):S210-7

 

Masujiro Makita

Department of Breast Surgery, Cancer Institute Hospital, Tokyo, Japan