Ductoscopy Coupled to Duct Lavage and Duct Brushing in Pathologic Nipple Discharge: Our Experience
Stefanos Zervoudis, Georgios Iatrakis, Jean-Pierre Daures, Anastasia Bothou, Vasilis Aranitis, Xaralambos Patralexis, Georgios Tsatsaris, Iordanis Navrozoglou, Panagiotis Tsikouras, Minas PaschopoulosOriginal article, no. 3, 2020
Article DOI: 10.21614/chirurgia.115.3.334
Purpose: to present our experience in the management of pathological nipple discharge using the procedure D.DL.DB: "ductoscopy" (D) coupled to "duct lavage" (DL) plus "duct brushing" (DB) for etiologic diagnosis.
Also to compare the diagnosis obtained with D.DL.DB to the final histology.
Material and Method:: Eighty-five patients with organic unilateral nipple discharge were enrolled in two Breast Units. 82 of 85 patients were investigated successfully with D.DL.DB.
Results:: The final histological results were: papilloma 46.3%, duct ectasia 36.5%, breast cancer 8.5%, precancer lesions 4.9%, and mixed benign lesions 3.8%. Pyramidectomy and radical ductectomy were performed in 76 and 6 cases respectively. In 80% of the cases, DLDB cytology results were identical to the final histology. (Kappa=0;69 CI=[0.56 -0.82].
The sensitivity of D.DL.DB versus pathology, for cancer or precancer lesions was 81.8% (CI=0.59 -1) and the specificity was 97.1% (CI=0.93 -1).
Using Koch scale, the concordance between the two methods D.DL.DB and surgery was high and the sensitivity was in the upper range regarding the literature (58% to 90%).
Conclusion:: Our experience confirms the high value of D.DL.DB in the management of organic nipple discharge.
Also to compare the diagnosis obtained with D.DL.DB to the final histology.
Material and Method:: Eighty-five patients with organic unilateral nipple discharge were enrolled in two Breast Units. 82 of 85 patients were investigated successfully with D.DL.DB.
Results:: The final histological results were: papilloma 46.3%, duct ectasia 36.5%, breast cancer 8.5%, precancer lesions 4.9%, and mixed benign lesions 3.8%. Pyramidectomy and radical ductectomy were performed in 76 and 6 cases respectively. In 80% of the cases, DLDB cytology results were identical to the final histology. (Kappa=0;69 CI=[0.56 -0.82].
The sensitivity of D.DL.DB versus pathology, for cancer or precancer lesions was 81.8% (CI=0.59 -1) and the specificity was 97.1% (CI=0.93 -1).
Using Koch scale, the concordance between the two methods D.DL.DB and surgery was high and the sensitivity was in the upper range regarding the literature (58% to 90%).
Conclusion:: Our experience confirms the high value of D.DL.DB in the management of organic nipple discharge.
Keywords: breast ductoscopy, duct lavage, duct brushing, nipple discharge, microductectomy,pyramidectomy
