The Value Of Minimally Invasive Surgery Of Intraductal Lesions Under The Guidance Of Breast Localization Needle

Objective To evaluate the value of breast fiberoptic ductoscopy and breast localization needle for the diagnosis and microinvasive treatment of intraductal lesions.Methods A total of 186 patients with nipple discharge without breast lumps were examined by breast fiberoptic ductoscopy in our hospital.118 patients were found to have intraductal lesions.Of them,45 patients were stained with Methylthioninium Chloride and received excision of the whole stained gland or sector,which were sent for intraoperative frozen.73 patients were localized with breast localization needle and received arc incision of the areola of the breast and excision of the localized breast duct with 1cm 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 intraductal papillomatosis;and simple mastectomy combined with DIEP reconstruction was carried out for the patients with intraductal carcinoma.Results Methylthioninium Chloride Group: Frozen and postoperative pathology showed single intraductal papilloma in 13 of the patients,duct papillomatosis in 2, and the others were adenopathies.The volumn of excisional tissue is (36.31±1.24)ml.The nipple is slightly retracted and shifted.Localization.Needle Group: Frozen and postoperative pathology showed single intraductal papilloma in 62 of the patients,intraductal papillomatosis in 5,DCIS in 3,and the other two were adenopathies.The volumn of excisional tissue is (15.55±1.09)ml.There is no nipple retraction and shifting.There is significant difference in volumn of excisional tissue between the two groups(t=95.396,P<0.05).The detection rate of intraductal lesions and DCIS in Localization Needle Group is higher than that in Methylthioninium Chloride Group(P<0.05).Conclusions Resection of intraductal lesions under the guidance of breast localization needle is less traumatic with good cosmetic outcomes. It is not only helpful for more accurate localization and resection as well as pathologic sampling, but also is minimally invasive. By using the method,high detection rate of intraductal lesions and DCIS can be achieved.