RESUMO
Objective To investigate the diagnostic value of fiberoptic ductoscopy (FDS) in pathological milky white nipple discharge.Methods The data of 1688 patients with pathological milky white nipple discharge who underwent FDS examination in Chengdu Third People's Hospital from Oct.2011 to Oct.2016 were analyzed retrospectively.Results Among the 1688 cases,the proportion of patients with milky white nipple discharge was 30％,higher than that of the bloody discharge (15％) and yellow liquid (24.5％).The detection rate of lesions in patients with milk nipple discharge was 9.3％,among whom 6.1％ was breast cancer.Conclusions FDS should be routinely performed in patients with pathological milky white nipple discharge,as an examination tool to exclude the intra ductal lesion.The disease should be paid more attention by physicians.
RESUMO
Conventional diagnostic methods used for pathologic nipple discharge (PND) include color ultrasound, mammary mo-lybdenum target X-ray radiography (mammography), nipple cytologic smears, and ductography. Diagnosis of PND through inspection yields indirect signs and has low positive rate. Fiberoptic ductoscopy (FDS) allows direct visualization of intra-ductal lesions, evaluates etiology of PND, and accurately locates intraductal lesions through wire marking. FDS is a valuable test for the early diagnosis of breast cancer and can help identify appropriate location for surgical excision. Interventional treatment for ductal ectasia and inflamma-tion is also efficient. Our study discusses FDS as a novel diagnosis and treatment method for PND patients.
RESUMO
Objective:To consolidate ten years of clinical experience on the application of breast fiberoptic ductoscopy (FDS) in breast intra-ductal lesion. Methods:The clinical data of 1 368 cases of patients with nipple discharge were retrospectively collected and analyzed. Results:Significant differences were observed in the FDS diagnoses of patients with nipple discharge. The rates of tumor de-tection by FDS diagnosis were significantly higher when bloody and serous nipple discharge was used rather than milky and watery nip-ple discharge. For non-tumor nipple discharge, local drug perfusion via FDS was an effective treatment. A total of 303 patients had tu-mor resection or segmentectomy under localization via FDS, and 44 had segmentectomy after breast duct infusion of methylene blue. The diagnostic rate of localization via FDS (97.0%) was higher than that of breast duct infusion of methylene blue (86.4%). Conclu-sion:FDS is an accurate method for diagnosing patients with nipple discharge. In addition, it is also a good local drug perfusion method for patients with breast inflammatory nipple discharge ductoscopy. For patients with tumorous nipple discharge, localization via FDS can help improve the detection of the lesions, which can be removed by surgery.
RESUMO
Objective Understand shunde Uistrict Foshan City,Guangdong Province in the incidence of breast cancer in women.Methods The joint selectivity ductoscopy examination of the clinical breast examination screening,breast X-ray radiography examination from March 2011 to January 2013,Shunde District,FoShan City,Guangdong Provice,3 600 bladder than 40 years old woman with breast cancer screening.Results Three thousand six hundred women were found in 10 cases of breast cancer,the detection rate of 278/100 000 (10/3 600).Breast clinical examination found 1 313 cases of breast abnormalities,142 cases of breast lumps,nipple discharge line fiberoptic ductoscopy to cheek the 100 cases,X-ray radiography examination of four and more than 72 cases,accounted for a total of 45.19％ of the screening population (1 627/3 600).Conclusions Joint ductoscopy X-ray radiography examination of breast cancer screening in the normal population can help to detect early breast cancer,and to provide the basis for early clinical treatment.
RESUMO
Objective To investigate the ultrasound diagnostic value for nipple discharge disease by comparison with fiberoptic ductoscopy. Methods Fiberoptic ductoscopy and ultrasonic inspection were performed on fifty-seven patients with spontaneous nipple discharge,and the results were analysed. Results In all patients, 55 cases (96. 49 % ) were abnormal in high-frequency ultrasound inspection:27 mammary duct expansion(47.36%),19 occupying lesion with mammary duct expansion or cyst (33.33%),6 cystic echo ( 10. 52% ) ,3 only solid echopattern (5.26%) ,and 2 nothing found (3.51% ). In ultrasonic inspection,color and pulse Doppler signal were found in 7 cases. On the other hand, 26 galactophoritis (45.61%), 12mammary duct ectasia (21.05 %), 17 intraductal papilloma (29.82%), 2 breast carcinoma (3.50%) were diagnosed by fiberoptic ductoscopy. In all 19 cases with occupying lesion,ultrasonography's sensitivity was 52. 63% ,specificity was 89. 47%, misdiagnosis rate was 10. 50%, rate of missed diagnosis was 47.36%.Conclusions To nipple discharge disease, high-frequency ultrasound has high sensitivity, easy to find abnormal indication,but is not accurate enough in the diagnosis of smaller occupying lesion.
RESUMO
Objective To explore the value of fiberoptic ductoseopy in diagnosis and treatment of nipple discharge diseases.Methods From March 2007 to March 2008,91 patients with nipple discharge were admitted in our hospital.These patients were diagnosed and treated using flberoptic ductoscope FVY-780,and their documents were retrospectively analyzed.Results All the 91 cases were successfully diagnosed and treated with fiberoptic ductoscopy.54 cases(59.3%) were diagnosed as protrusion lesions,19 of whom experinced multiple protrusion,and 5 cases(5.5%) of early breast carcinoma were confirmed by postoperative pathology.37 patients(40.7%) diagnosed as non-protrusion lesions were treated by irrigation therapy,some of whom improved or cured.Conclusions Fiberoptic ductoseopy is the first choice of examination for nipple discharge,and it has important clinical values in choosing procedures for it can show precisely the cause and lesion site.Surgery can thereby be avoided for non-protrusion lesions.Locating the site of lesions in mammary ducts guided by fiberoptic duetoscopy may make operations more accurate and minimally invasive.
RESUMO
Objective To investigate whether the bilateral nipple discharge with the background of hypothyroidism and pituitary tumor causes intraductal neoplasm. Methods Clinical data of 222 bilateral nipple discharge patients with hypothyroidism or pituitary tumor undergoing mammary ductoseopy (MDS) examination were analyzed. Those diagnosed as intraductal papilloma received surgery and pathological exam. 158 cases with inflammatory comedomastitis diagnosed by MDS received milk duct washing with gentamycin, dexamethasone and corresponding medical treatment. Results Among the 222 cases, 158 cases(71.17%) were diagnosed as inflammatory comedomastitis by MDS, 64 cases (28.83%) were diagnosed as intraduetal papilloma (64/222) by MDS and received operation,59 cases were pathologically diagnosed as intraductal papilloma,the other 5 cases were pathologically diagnosed as mammary duct ectasia. The pathological coincidence was 92.2% and no breast cancer was observed. 68.10% of inflammatory comedomastitis cases suffered from breast pain. There were no significant difference in the disease distribution of the ethnic groups. During pre-menopause period, the incidence of period neoplasia is higher in pituitary tumor than hypothyroidism; However, during the post-menopause the situation was vice versa. The color of niplle discharge is mostly milk-like in patients with pituitary tumor, while serous in patients with hypothyroidism. 71.19% of duct papilloma locate at the branch of the main duct. Conclusion The bilateral nipple discharge with hypothyroidism or pituitary are usually concomitant with intraduetal lesions. Mammary ductosopy is helpful to discover intraduetal neoplasia.
RESUMO
Objective To evaluate the clinical value of fiberoptic ductoscopy in diagnosis and treatment of patients with galactophoritis or mammary duct ectasia. Methods From November 2005 to March 2008, fiberoptic ductoscopy were performed in 120 women with nipple discharge. The duct of 95 cases as non-malignant lesion were insufflated and perfusioned with entamycin and dexamethasone. Results Ninty-five of 120 cases were non-malignant disease,which contained one side 81 and two sides 14; the discharge was bloody,ivory, stramineous in 21, 17, 57 patinents, respectively; and the dignosis were 17 mammary duct ectasia, 53 galactophoritis, and 25 mammary duct ectasia with galactophoritis. Of the 95 cases, hich were intradutal insufflated and perfusioned with gentamycin and dexamethasone, the nipple discharge were decreased or disappeared in 81 cases, the effective rate was 85.3%. Conclusion Fiberoptic ductoscopy is a convenient,safe, accurate method in diagnosis and treatment of patients with galactophoritis or mammary duct ectasia.
RESUMO
Background and purpose:Nipple secretion is one of the frequent symptoms in mammary gland disease.Clinically,about 1% breast cancer patients demonstrate with nipple secretion as initial symptom.It could be used as a screening tool for the patients with nipple secretion but no palpated mass and increase the possibility of early diagnosis for breast cancer.In 1997,our country developed a new technique——breast fiberoptic ductoscopy(FDS). It uses a ?(0.7) millimeter optic scope to insert into the nipple discharge canal orifice,and depends on introscope technology to observe and record the normal or abnormal changes in mammary gland ductus.Its advantages are not only in highly diagnostic sensitivity(above 90%),but also in accurate location of tumor,so it can be used to diagnose early breast cancer and mammary gland ductal diseases.This study evaluated the clinical effect of breast FDS in diagnosis and treatment of abnormal nipple secretion.Methods:1 000 patients had been under examination by FDS.Results:Of the 1 000 cases,there were 33 cases((3.3%)) of early breast cancer;412 cases(41.2%) of papilloma and papillomatosis;and 480 cases(48%) of either ductal ectasia and or chronic inflammation.Duct endoscoptic biopsy was successfully performed on 30 cases,220 cases(55%) with chromic inflammation were cured by perfusion.453 cases were received operation.The accordance rate with pathologic eiagnosis was 90.7%.Conclusions:FDS is a very important and new method to diagnose breast.FDS could be inserted into 5th ducta lumen of breast and significantly increase the positive detection of breast cancer.Because the position and nature of the lesions can be determined accurately by FDS,tt is used as intervening treatment for some intraductal papilloma and chronic inflammatory disease.FDS will be of great influence on early diagnoses and treatment of the breast cancer.
RESUMO
Objective To investigate the value of the expressions of estrogen receptor(ER)and progesterone receptor(PR)in the cast-off cells from the fluid of latex ductal lavage in the diagnosis and treatment of breast diseases.Methods A total of 58 female out-patients were examined by fiberoptic ductoscopy(FDS).All patients were divided into 6 groups by the complaints,physical examination,ultrasound and FDS:normal group(10 persons without symptoms and abnormalities in any examination),galactostasis group(n=19),latex fill up group(n=11),intraductal papilloma group(n=2),mammary ductal ectasia group(n=7)and contralateral examination after mastectomy for breast cancer group(n=9).A total of 168 ducts were successfully examined by FDS,and the expressions of ER and PR in the cast-off cells were detected among all of the samples.Results The positive rates of ER and PR expression in the cast-off cells from the fluid of latex ductal lavage in benign breast disease groups were much higher than those in normal group(P
RESUMO
Objective To explore efficacy of mammary ductoscopy in diagnosis and treatment of nipple discharge.Methods 206 cases of nipple discharge underwent 211 examinations of mammary ductoscopy from May 2001 to October 2006.Results Fifty-eight patients diagnosed as non-protrusion lesions under mammary ductoscopy were treated by irrigation therapy and followed up for 3-18 months(mean,12 months) without recurrence.One hundred and forty-eight cases were diagnosed as protrusion lesions,in which 125 cases received operation.115 cases of single mammary intraductal papilloma,7 cases of papillomatosis,and 3 cases of intraductal carcinoma were diagnosed under mammary ductoscopy,while 112 case of intraductal papilloma,10 cases of papillomatosis and 3 cases of ductal carcinoma were confirmed by postoperative pathology.Of the 125 cases,mammary ducts resection was carried out in 120 cases guided by locating needle,segment mammectomy in 1 case,"mammary gland displacement" in 1 case,quadrant resection with nipple-conserving combined with axillary lymph node dissection in 1 case,quadrant resection without nipple-conserving combined with axillary lymph node dissection in 2 cases.Follow-up for 4 to 20 months(mean,10 months) showed no recurrence.3 cases of ductal carcinoma in situ were followed up for 12-18 months,and survived with tumor-free.Conclusions Mammary ductoscopy examination makes accurate diagnosis of nipple discharge induced by intraductal carcinoma before operation,and has important clinical value to choose procedures.Locating needles to locate lesions in mammary ducts may be taken as a guide during operation.
RESUMO
Objective To assess the value of the resection of mammary intraductal tumors under ultra-fine fiberoptic ductoscopy.Methods Ductoscopic examinauions were performed in 312 patients with nipple discharge,and those with positive findings of intraductal tumors were given further surgical treatment.The location of lesions was determined according to the position of skin projection of the cold light source,the passage of the mammary ducts was determined depending on the direction of intraductal dilatator,and the distribution of the distal ends of mammary ducts was determined with methylene blue staining.Results Intraductal tumors were found in 78 cases,including solitary papilloma in 68 cases,papillomatosis in 5 cases,and intraductal carcinoma in 5 cases.The lesions were located at the major mammary ducts in 22 cases(28.2%,22/78),at the first branches of segmental ducts in 38 cases(48.7%,38/78),at the second branches in 14 cases(17.9%,14/78),at the third branches in 3 cases(3.8%,3/78),and at the fourth branches in 1 case(1.3%,1/78).The distance between the lesions and the lacteal outlet was 1~5 cm(mean,2.5 cm).All the 78 cases were surgically treated.Postoperative pathological findings revealed 65 cases of papilloma,8 cases of papillomatosis,and 5 cases of intraductal carcinoma.The diagnostic accordance rate of ductoscopy was 96%(65/68) for papilloma and 100% for papillomatosis(5/5) and intraductal carcinoma(5/5).There were 65 cases of ductectomy,8 cases of segmentectomy,3 cases of breast-conserving radical resection,and 2 cases of modified radical resection.Conclusions On the basis of the position of skin projection of the cold light source,the direction of intraductal dilatator,and the methylene blue staining,the location of lesion can be accurately identified for precise resection,which carries out a minimally invasive treatment for mammary intraductal tumors.
RESUMO
Objective To discuss the clinical value of f iberoptic ductoscopy in the diagnosis and treatment of breast diseases. Methods A total of 3 000 patients with mastalgia, breast mass or ni pple discharge received examinations by fiberoptic ductoscopy. Cytological exami nations were carried out in part of the patients after ductoscopy. Resu lts Of the 3 000 cases, there were 608 cases of intraductal space-occup ying lesions, 1 709 cases of obstructive galactophoritis, 350 cases of galactost asia, 24 cases of acute galactophoritis, 282 cases of simple mammarv duct ectasi a, and 27 cases of normal mammary ducts. Of 1 167 patients with nipple discharge , intraductal space-occupying lesions were clarified by ductoscopy in 585 cases (50%). Surgery was performed in 643 cases while intraductal interventional thera py was adopted in 2 365 cases. Conclusions Fiberoptic ductosco py may be used for the diagnosis and treatment of various breast diseases, not c onfined to nipple discharge.
RESUMO
Objective:Nipple discharge is a common complaint in women.There were no accurate techniques in detecting ductal lesions in nipple discharge patients before the application of fiberoptic ductoscopy.The aim of this study was to evaluate fiberoptic ductoscopy in the diagnosis and treatment of nipple discharge.Methods: From June 2007 to November 2008,a total of 95 patients with nipple discharge were submitted to fiberoptic ductoscopy,and 50 of them underwent surgery and pathological examination.Results: Of the 95 cases,2 diagnosed as breast cancer,58 intraductal papilloma,23 mammary duct ectasia,and 10 inflammatory disease of the mammary duct.Compared with the results of pathological examination,the accuracy of the fiberoptic ductoscopy was 81% for intraductal papilloma and 100% for breast carcinoma.Conclusions:Fiberoptic ductoscopy,as a convenient,safe and accurate method for the diagnosis and treatment of nipple discharge,can be used to confirm etiological factors and locate the site of the complaint.
RESUMO
Objective To introduce the current status of clinical application, value and perspective of fiberoptic ductoscopy.Methods The related literatures on advances in clinical application of fiberoptic ductoscopy were reviewed.Results Fiberoptic ductoscopy is now widely used in breast diseases, especially complicated with nipple discharge, and it has a higher accuracy rate than routine examinations. With ductoscopy, ductal lavage,location, biopsy and treatment can be carried out.Conclusion Fiberoptic ductoscopy has a greater value in diagnosis and treatment, we believe it will be better applied and further developed.
RESUMO
Objective To discuss the diagnosis and treatment of ductoscopy for intraductal non-protruding lesions. Methods A retrospective analysis was made on characteristics, morphological features, and curative effects of 165 cases of intraductal non-protruding lesions between December 2002 and October 2005. Results Among the 165 cases, there were 135 cases of plasma cell galactophoritis, 18 cases of cystic mastopathy, and 12 cases of galactophoritis. In 144 cases receiving non-surgical treatment, 82 cases were completely relieved and 62 improved. Other 21 cases of plasma cell galactophoritis were surgically treated. Conclusions Mammary ductoscopy is an important way for the diagnosis of intraductal non-protruding lesions. Furthermore, effective treatment can be achieved under ductoscopy in most of cases, and unnecessary surgery may be avoided.
RESUMO
Objective To investigate subsequent treatment methods of nipple discharge after fiberoptic ductoscopic examination.Methods Intraductal lesions of 51 patients with nipple discharge were observed and assessed by fiberoptic ductoscopy.After examination,the patients were treated by various methods according to characteristic appearance of lesions under fiberoptic ductoscopy.The type of lesion with nipple discharge was classified as papillary lesions and nonpapillary lesions.And the papillary lesions could be further subdivided into nodular papillary lesions and irregular papillary lesions.There were 29 cases of nodular papillary lesion,23 of which were treated by local resection and 6 of which were given a simple mammectomy.There was 1 case of irregular papillary lesion,which was treated as malignant tumor after the focus was surgically removed and pathologically confirmed as breast cancer.Nonpapillary lesion was observed in 21 cases,18 of which were treated by local irrigation under ductoscopy,and 3 of which were treated as malignant tumor after the abnormal duct with its lobules was pathologically diagnosed as breast cancer.Results The 51 patients were followed with B-ultrasonography or chest roentgenography for 6～21 months(mean,14 months).No recurrence or metastasis was observed.Conclusions The characteristic appearance of lesion with nipple discharge under fiberoptic ductoscopy is an important evidence for choosing treatment method.
RESUMO
Objective To discuss the efficacy of fiberoptic ductoscopy(FDS)in the treatment of mammary duct diseases with nipple discharge.Methods Fiberoptic ductoscopy was utilized for diagnosing and treating exudative lesions in the mammary duct in 72 cases(80 sides).After the lesion was detected under ductoscope,repeated irrigation using normal saline was performed until the flocculent discharge disappeared.Intraductal drug administration(dexamethasone 5 mg and gentamycin 40 000 U)was given during the retreat of ductoscope.Results There were 57 sides of galactophoritis and 23 sides of mammary duct ectasia.A complete recovery was achieved in 65 sides(nipple discharge disappeared completely and no relapse occurred in 6 months),in which a follow-up for 1～2 years showed no recurrence.A remarkable improvement was obtained in 15 sides(nipple discharge significantly reduced,or progressively decreased within 6 months,or underwear wetted occasionally).Conclusions Fiberoptic ductoscopy in the treatment of mammary duct lesions with abnormal nipple discharge is effective.
RESUMO
Objective To assess the value of fiberoptic ductoscopy (FDS) in the diagnosis of nipple discharge.Methods Clinical records of 800 patients with nipple discharge undergoing FDS from October 1998 to July 2003 were retrospectively reviewed. Results Diagnoses established by FDS were pathologically confirmed in 92 2% of patients with papilloma (202/219), in 86 7% of patients with papillomatosis (13/15), and in 95 2% of patients with breast cancer (40/42). The total diagnostic accordance rate was 92 0% (266/289). Conclusions FDS in the diagnosis of nipple discharge is sensitive and of great clinical significance.
RESUMO
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.