Excision of Intraductal Lesions under the Guidance of Breast Localization Needle / 中国微创外科杂志

Objective To evaluate the value of breast duct endoscopy and breast localization needle for the diagnosis and microinvasive treatment of intraductal lesions. Methods A total of 103 patients with nipple discharge without breast lumps were examined by breast duct endoscopy in our hospital. Of them, 63 cases of intraductal lesions were localized with breast localization needle and received arc incision of the areola of the breast and excision of the localized breast duct with 1-cm adjacent tissues, which were sent for intraoperative frozen. After the frozen pathological examination, the operation was ended for the patients with intraductal papilloma; simple mastectomy was performed on those with duct papillomatosis; and simple mastectomy combined with DIEP reconstruction was carried out for the patients with intraductal carcinoma. Results Frozen and postoperative pathological examinations showed single intraductal papilloma in 59 of the patients (59/63, 93.6%), duct papillomatosis in 2 (2/63, 3.2%) , and intraductal carcinoma in 2 (2/63, 3.2%). The 59 patients with single intraductal papilloma were reexamined in 3 months after the operation, none of them had nipple discharge or other symptoms. Conclusions Resection of intraductal lesions under the guidance of breast localization needle is less traumatic with good cosmetic outcomes. By using the method, high rates of complete resection and accuracy of pathological examination can be achieved.

A report of 15 cases of intraductal papillomatosis / 中国微创外科杂志

Objective To discuss the diagnosis and treatment of intraductal papillomatosis. Methods Fifteen cases of intraductal papillomatosis were analyzed retrospectively. Results Of the 15 cases,preoperative diagnosis of intraductal papillomatosis was made in 8 cases who had received fiberoptic ductoscopy,while the rest of 7 cases who had not undergone ductoscopy were wrongly diagnosed.Postoperative pathological findings revealed 2 cases of partial malignant change and 1 case of contralateral infiltrating lobular carcinoma.Reoperation was required in 3 cases because of relapse,the relapse rate being 20%. Conclusions Intraductal papillomatosis is absolutely different from intraductal papilloma.It presents the potentiality of malignancy,and is subject to relapse after local resection.Fiberoptic ductoscopy may improve the diagnosis rate for this disease.

A report of 103 cases of breast intraductal papillomatosis (BIDP) / 解放军医学杂志

Objective To analyze the relationship between BIDP and breast cancer, and to evaluate the treatment of BIDP. Methods 103 cases of BIDP were studied retrospectively in respect of its clinical and pathological features, diagnosis, and treatment. Results Among the patients, there were 102 women and 1 man. The diagnosis was all verified by pathological examination. The rate of misdiagnosis was high(62.1%). Local excision was performed in 18 patients, regional lobular excision in 62, in nine patients modified radical mastectomy for malignant change in 9 patients, and simple excision for malignancy in 2 patients. The recurrent rate after local excision was 11.7% after 13 years, and the rate of malignant change was 6.8%. Conclusions To sum up the relationship and differentiate method between BIDP and Breast Cancer, and briefly discuss the methods of treatment.