Resection of mammary intraductal tumors under ultra-fine fiberoptic ductoscopy / 中国微创外科杂志

ABSTRACT

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.