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Published in: Annals of Surgical Oncology 12/2008

01-12-2008 | Breast Oncology

The Role of Mammary Ductoscopy in Breast Cancer: a Review of the Literature

Authors: Edna Kapenhas-Valdes, MD, Sheldon M. Feldman , MD, FACS, Susan K. Boolbol, MD

Published in: Annals of Surgical Oncology | Issue 12/2008

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Abstract

Breast cancer is the most frequently diagnosed malignancy among American women. It is the second most common cause of cancer death. Genetic analysis using comparative genetic hybridization (CGH) has shown evidence that the majority of breast cancers, approximately 85%, begin in the ductal epithelium with normal cells progressing to atypia and finally to carcinoma. Mammary ductoscopy, also referred to as the intraductal approach, is a new tool that allows direct visualization of the breast ductal system. It enables one to sample the ductal epithelium and may allow identification of early changes cytologically as well as potentially play an important role in aiding surgical excision. This may aid in detection of breast masses long before they are palpable or visible via mammography. Mammary ductoscopy may have a role in the evaluation of women with nipple discharge, high-risk women, or limiting the amount of tissue removed in breast conservation surgery for cancer.
Literature
1.
go back to reference Shao ZM, Liu Y, Nguyen M. The role of the breast ductal system in the diagnosis of cancer (review). Oncol Rep 2001; 8:153–6PubMed Shao ZM, Liu Y, Nguyen M. The role of the breast ductal system in the diagnosis of cancer (review). Oncol Rep 2001; 8:153–6PubMed
2.
go back to reference Shao ZM, Nguyen M. Nipple aspiration in diagnosis of breast cancer. Semin Surg Oncol 2001; 20:175–80PubMedCrossRef Shao ZM, Nguyen M. Nipple aspiration in diagnosis of breast cancer. Semin Surg Oncol 2001; 20:175–80PubMedCrossRef
3.
4.
go back to reference Gong G, DeVries S, Chew KL, et al. Genetic changes in paired atypical and usual ductal hyperplasia of the breast by comparative genomic hybridization. Clin Cancer Res 2001; 7:2410–4PubMed Gong G, DeVries S, Chew KL, et al. Genetic changes in paired atypical and usual ductal hyperplasia of the breast by comparative genomic hybridization. Clin Cancer Res 2001; 7:2410–4PubMed
5.
go back to reference Wrensch MR, Petrakis NL, King EB, et al. Breast cancer incidence in women with abnormal cytology in nipple aspirates of breast fluid. Am J Epidem 1992; 135:130–41 Wrensch MR, Petrakis NL, King EB, et al. Breast cancer incidence in women with abnormal cytology in nipple aspirates of breast fluid. Am J Epidem 1992; 135:130–41
6.
go back to reference Shen KW, Wu J, Lu JS, et al. Fiberoptic ductoscopy for patients with nipple discharge. Cancer 2000; 89:1512–9PubMedCrossRef Shen KW, Wu J, Lu JS, et al. Fiberoptic ductoscopy for patients with nipple discharge. Cancer 2000; 89:1512–9PubMedCrossRef
7.
go back to reference Shen KW, Wu J, Lu JS, et al. Fiberoptic ductoscopy for breast cancer patients with nipple discharge. Surg Endosc 2001; 15:1340–5PubMedCrossRef Shen KW, Wu J, Lu JS, et al. Fiberoptic ductoscopy for breast cancer patients with nipple discharge. Surg Endosc 2001; 15:1340–5PubMedCrossRef
8.
go back to reference Love SM, Barsky SH. Breast-duct endoscopy to study stages of cancerous breast disease. Lancet 1997; 348:997–9CrossRef Love SM, Barsky SH. Breast-duct endoscopy to study stages of cancerous breast disease. Lancet 1997; 348:997–9CrossRef
9.
10.
go back to reference Matsunaga T, Ohta D, Misaka T, et al. Mammary ductoscopy for diagnosis and treatment of intraductal lesions of the breast. Breast Cancer 2001; 8:213–21PubMedCrossRef Matsunaga T, Ohta D, Misaka T, et al. Mammary ductoscopy for diagnosis and treatment of intraductal lesions of the breast. Breast Cancer 2001; 8:213–21PubMedCrossRef
11.
go back to reference Dietz JR, Kim JA, Malycky JL, et al. Feasibility and technical consideration of mammary ductoscopy in human mastectomy specimens. Breast J 2000; 6:161–5PubMedCrossRef Dietz JR, Kim JA, Malycky JL, et al. Feasibility and technical consideration of mammary ductoscopy in human mastectomy specimens. Breast J 2000; 6:161–5PubMedCrossRef
12.
go back to reference Yamamoto D, Shoji T, Kawanishi H, et al. A utility of ductography and fiberoptic ductoscopy for patients with nipple discharge. Breast Cancer Res Treatment 2001; 70:103–8CrossRef Yamamoto D, Shoji T, Kawanishi H, et al. A utility of ductography and fiberoptic ductoscopy for patients with nipple discharge. Breast Cancer Res Treatment 2001; 70:103–8CrossRef
13.
go back to reference Dooley WC. Ductal lavage, nipple aspiration, and ductoscopy for breast cancer diagnosis. Curr Oncol Rep 2003; 5:63–5PubMedCrossRef Dooley WC. Ductal lavage, nipple aspiration, and ductoscopy for breast cancer diagnosis. Curr Oncol Rep 2003; 5:63–5PubMedCrossRef
14.
go back to reference Dietz JR, Crowe JP, Grundfest S, et al. Directed duct excision by using mammary ductoscopy in patients with pathological nipple discharge. Surgery 2002; 132:582–8PubMedCrossRef Dietz JR, Crowe JP, Grundfest S, et al. Directed duct excision by using mammary ductoscopy in patients with pathological nipple discharge. Surgery 2002; 132:582–8PubMedCrossRef
15.
go back to reference Edney JA. Breast cancer-treatment for the future based on lessons from the past. Am J Surg 2002; 184:477–83PubMedCrossRef Edney JA. Breast cancer-treatment for the future based on lessons from the past. Am J Surg 2002; 184:477–83PubMedCrossRef
16.
go back to reference Makita M, Akiyama F, Gomi N, et al. Endoscopic classification of intraductal lesions and histological diagnosis. Breast Cancer 2002; 9:220–5PubMedCrossRef Makita M, Akiyama F, Gomi N, et al. Endoscopic classification of intraductal lesions and histological diagnosis. Breast Cancer 2002; 9:220–5PubMedCrossRef
17.
go back to reference Okazaki A, Okazaki M, Asaishi K, et al. Fiberoptic ductoscopy of the breast: a new diagnostic procedure for nipple discharge. Jpn J Clin Oncol 1991; 21:188–93PubMed Okazaki A, Okazaki M, Asaishi K, et al. Fiberoptic ductoscopy of the breast: a new diagnostic procedure for nipple discharge. Jpn J Clin Oncol 1991; 21:188–93PubMed
18.
go back to reference Okazaki A, Hirata K, Okazaki M, et al. Nipple discharge disorders: current diagnostic management and the role of fiber-ductoscopy. Eur Radiol 1999; 9:583–90PubMedCrossRef Okazaki A, Hirata K, Okazaki M, et al. Nipple discharge disorders: current diagnostic management and the role of fiber-ductoscopy. Eur Radiol 1999; 9:583–90PubMedCrossRef
19.
go back to reference Dooley WC. Routine operative breast endoscopy for bloody nipple discharge. Ann Surg Oncol 2002; 9:920–3PubMedCrossRef Dooley WC. Routine operative breast endoscopy for bloody nipple discharge. Ann Surg Oncol 2002; 9:920–3PubMedCrossRef
21.
go back to reference Makita M, Sakamoto G, Akiyama F, et al. Duct endoscopy and endoscopic biopsy in the evaluation of nipple discharge. Breast Cancer Res Treatment 1991; 18:179–88CrossRef Makita M, Sakamoto G, Akiyama F, et al. Duct endoscopy and endoscopic biopsy in the evaluation of nipple discharge. Breast Cancer Res Treatment 1991; 18:179–88CrossRef
22.
go back to reference Baitchev G, Gortchev G, Todorova A, et al. Intraductal aspiration cytology and galactography for nipple discharge. Int Surg 2003; 88:83–6PubMed Baitchev G, Gortchev G, Todorova A, et al. Intraductal aspiration cytology and galactography for nipple discharge. Int Surg 2003; 88:83–6PubMed
23.
go back to reference Cabioglu N, Hunt KK, Singletary SE, et al. Surgical decision making and factors determining a diagnosis of breast carcinoma in women presenting with nipple discharge. J Am Coll Surg 2003; 196:354–64PubMedCrossRef Cabioglu N, Hunt KK, Singletary SE, et al. Surgical decision making and factors determining a diagnosis of breast carcinoma in women presenting with nipple discharge. J Am Coll Surg 2003; 196:354–64PubMedCrossRef
24.
go back to reference Groves AM, Carr M, Wadhera V, et al. An audit of cytology in the evaluation of nipple discharge. A retrospective study of 10 years’ experience. The Breast 1996; 5:96–9CrossRef Groves AM, Carr M, Wadhera V, et al. An audit of cytology in the evaluation of nipple discharge. A retrospective study of 10 years’ experience. The Breast 1996; 5:96–9CrossRef
25.
go back to reference Ciatto S, Bravetti P, Cariaggi P. Significance of nipple discharge clinical patterns in the selection of cases for cytologic examination. Acta Cytologica 1986; 30:17–20PubMed Ciatto S, Bravetti P, Cariaggi P. Significance of nipple discharge clinical patterns in the selection of cases for cytologic examination. Acta Cytologica 1986; 30:17–20PubMed
26.
go back to reference Dunn JM, Lucarotti ME, Wood SJ, et al. Exfoliative cytology in the diagnosis of breast disease. Br J Surg 1995; 82:789–91PubMedCrossRef Dunn JM, Lucarotti ME, Wood SJ, et al. Exfoliative cytology in the diagnosis of breast disease. Br J Surg 1995; 82:789–91PubMedCrossRef
28.
go back to reference Van Zee KJ, Perez GO, Minnard E, et al. Preoperative galactography increases the diagnostic yield of major duct excision for nipple discharge. Cancer 1998; 82:1874–80PubMedCrossRef Van Zee KJ, Perez GO, Minnard E, et al. Preoperative galactography increases the diagnostic yield of major duct excision for nipple discharge. Cancer 1998; 82:1874–80PubMedCrossRef
29.
go back to reference Berna JD, Garcia-Medina V, Kuni CC. Ductoscopy: a new technique for ductal exploration. Eur J Radiol 1991; 12:127–9PubMedCrossRef Berna JD, Garcia-Medina V, Kuni CC. Ductoscopy: a new technique for ductal exploration. Eur J Radiol 1991; 12:127–9PubMedCrossRef
30.
go back to reference Hunerbein M, Schwarz LE, Schneider U, et al. Evaluation of pathologic nipple discharge with ductoscopy. J Am Coll Surg Lett Ed 2003; 697–8 Hunerbein M, Schwarz LE, Schneider U, et al. Evaluation of pathologic nipple discharge with ductoscopy. J Am Coll Surg Lett Ed 2003; 697–8
31.
go back to reference Fabian CJ, Kimler BF, Zalles CM, et al. Short-term breast cancer prediction by random periareolar fine-needle aspiration cytology and the Gail risk model. J Natl Cancer Inst 2000; 92:1217–27PubMedCrossRef Fabian CJ, Kimler BF, Zalles CM, et al. Short-term breast cancer prediction by random periareolar fine-needle aspiration cytology and the Gail risk model. J Natl Cancer Inst 2000; 92:1217–27PubMedCrossRef
32.
go back to reference Dupont WD, Page DL. Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med 1985; 312:146–51PubMed Dupont WD, Page DL. Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med 1985; 312:146–51PubMed
33.
go back to reference Dupont WD, Parl FF, Hartmann WH, et al. Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer 1993; 71:1258–65PubMedCrossRef Dupont WD, Parl FF, Hartmann WH, et al. Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer 1993; 71:1258–65PubMedCrossRef
34.
go back to reference Page DL, Dupont WD, Rogers LW, et al. Atypical hyperplastic lesions of the female breast. A long-term follow-up study. Cancer 1985; 55:2698–708PubMedCrossRef Page DL, Dupont WD, Rogers LW, et al. Atypical hyperplastic lesions of the female breast. A long-term follow-up study. Cancer 1985; 55:2698–708PubMedCrossRef
35.
go back to reference Fisher B, Constantino JP, Wickerham DL, et al. Tamoxifen for prevention of breast cancer: Report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 1998; 90:1371–88PubMedCrossRef Fisher B, Constantino JP, Wickerham DL, et al. Tamoxifen for prevention of breast cancer: Report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 1998; 90:1371–88PubMedCrossRef
36.
go back to reference Khan SA, Baird C, Staradub VL, et al. Ductal lavage and ductoscopy: the opportunities and the limitations. Clin Breast Cancer 2002; 3:185–91; discussion 192–5. ReviewPubMedCrossRef Khan SA, Baird C, Staradub VL, et al. Ductal lavage and ductoscopy: the opportunities and the limitations. Clin Breast Cancer 2002; 3:185–91; discussion 192–5. ReviewPubMedCrossRef
38.
39.
go back to reference Kim JA, Crowe JP, Woletz J, et al. Prospective study of intraoperative mammary ductoscopy in patients undergoing partial mastectomy for breast cancer. Am J Surg 2004; 188:411–4PubMedCrossRef Kim JA, Crowe JP, Woletz J, et al. Prospective study of intraoperative mammary ductoscopy in patients undergoing partial mastectomy for breast cancer. Am J Surg 2004; 188:411–4PubMedCrossRef
40.
go back to reference Valdes EK, Boolbol SK, Cohen JM, et al. Clinical experience with mammary ductoscopy. Ann Surg Oncol. July 2006 [Epub ahead of print] Valdes EK, Boolbol SK, Cohen JM, et al. Clinical experience with mammary ductoscopy. Ann Surg Oncol. July 2006 [Epub ahead of print]
41.
go back to reference Dinkel HP, Trusen A, Gassel AM, et al. Predictive value of galactographic patterns for benign and malignant neoplasms of the breast in patients with nipple discharge. Br J Radiol 2000;73:706–14PubMed Dinkel HP, Trusen A, Gassel AM, et al. Predictive value of galactographic patterns for benign and malignant neoplasms of the breast in patients with nipple discharge. Br J Radiol 2000;73:706–14PubMed
42.
go back to reference Hild F, Duda VF, Albert U, et al. Ductal orientated sonography improves the diagnosis of pathological nipple discharge of the female breast compared with galactography. Eur J Cancer Prev 1998; 7:S57–62PubMedCrossRef Hild F, Duda VF, Albert U, et al. Ductal orientated sonography improves the diagnosis of pathological nipple discharge of the female breast compared with galactography. Eur J Cancer Prev 1998; 7:S57–62PubMedCrossRef
43.
go back to reference Sartorius OW, Morris PL, Benedict DL, et al. (1977) Contrast ductography for recognition and localization of benign and malignant breast lesions: an improved technique. In: Logan W (ed) Breast Carcinoma. Wiley, New York, pp 281–300 Sartorius OW, Morris PL, Benedict DL, et al. (1977) Contrast ductography for recognition and localization of benign and malignant breast lesions: an improved technique. In: Logan W (ed) Breast Carcinoma. Wiley, New York, pp 281–300
45.
go back to reference Knight DC, Lowell DM, Heimann A, et al. Aspiration of the breast and nipple discharge cytology. Surg Gynecol Obstet 1986; 163:415–20PubMed Knight DC, Lowell DM, Heimann A, et al. Aspiration of the breast and nipple discharge cytology. Surg Gynecol Obstet 1986; 163:415–20PubMed
46.
go back to reference Grunwald S, Heyer H, Paepke S, et al. Diagnostic value of ductoscopy in the diagnosis of nipple discharge and intraductal proliferations in comparison to standard methods. Onkologie 2007; 30:243–8PubMedCrossRef Grunwald S, Heyer H, Paepke S, et al. Diagnostic value of ductoscopy in the diagnosis of nipple discharge and intraductal proliferations in comparison to standard methods. Onkologie 2007; 30:243–8PubMedCrossRef
Metadata
Title
The Role of Mammary Ductoscopy in Breast Cancer: a Review of the Literature
Authors
Edna Kapenhas-Valdes, MD
Sheldon M. Feldman , MD, FACS
Susan K. Boolbol, MD
Publication date
01-12-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 12/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-9911-4

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