Diagnosis And Treatment Analysis Of Fiberoptic Ductoscopy In Patients With Breast Intraductal Diseases

ObjectiveTo explore the diagnosis and treatment value of fiberoptic ductoscopy(FDS) in patients with breast ductal diseases, the patients were negative by the cilical examination. MethodsFrom October 2014 to December 2015, 131 patients with breast intraductal disease underwent FDS, of which all patients were negative by the cilical examination. Patients with intraductal non-occupying nipple discharge line lumen lavage, those with intraductal occupying nipple discharge received either methylene blue or wire marking of the lesion before microdochectomy. ResultsOf all 131 breast disease patients received FDS examination successfully, and no abnormal findings in 5 cases; 33 cases were diagnosed as ductal dilatation and 19 cases were inflammatory lesions. By univariate analysis, we found our patients with unilateral, single duct, and bloody nipple discharge, were more likely to have intraductal occupying lesion. By multivariate analysis, unilateral, and bloody nipple discharge showed statistically significant correlations with intraductal occupying lesions. Breast cancer was more likely to have more than 50 years old,unilateral, single duct, and bloody nipple discharge. 74 cases underwent surgery, the pathological detection rate was 93.2%, there were 32 patients who received methylene blue marking and 37 cases who received wire marking of the lesions. There were no differences between the demographic or clinical characteristics of the groups. Wire marking was associated with less surgical time(p<0.05), smaller incisions(p<0.05), and smaller surgical specimens(p<0.05), but the same diagnostic accuracy(p>0.05). Five patients had negative cytology and normal conventional diagnostic imaging. All patients diagnosed with a nonsessile single papilloma underwent successful ductoscopic biopsy,the pathological detection proved all of these patients were papilloma. These patients had no recurrence of discharge or suspicious of malignancy after 12 months follow-up. Interventional treatment for ductal ectasia and inflammation is efficient and the effective rate is 87.7%. ConclusionPatients with unilateral, single duct, and bloody nipple discharge were more likely to have intraductal occupying lesion. Breast cancer was more likely to have more than 50 years old,unilateral, single duct, and bloody nipple discharge. Wire marking of lesions for microdochectomy is associated with less dissectional tissue damage than methylene blue, yet the same diagnostic accuracy. Those patients with adequate follow-up, benign papillomas may be managed conservatively. Ductoscopy is currently the most effective diagnostic and treatment method for pathologic nipple discharge patients.