Original articleMammary ductoscopy for the evaluation of nipple discharge and comparison with standard diagnostic techniques
Section snippets
Materials and methods
Our analysis includes an unselected series of continuous patients with nipple discharge and all data prospectively collected between April 2003 and April 2004. Initially, extramammary causes for nipple discharge were considered exclusion criterion and were ruled out. Subsequently, all patients with unilateral or bilateral nipple discharge underwent the variety of preoperative tests, such as mammography, breast ultrasonography, nipple smear, and minimally invasive diagnostics such as
Results
In this study 15 female patients were investigated. The average patient age was 49.9 years, range 30 to 74 years. Analysis included 20 breast examinations from 15 patients (10 patients with unilateral, 5 patients with bilateral nipple discharge). Nipple discharge was either reddish (n = 3; 15.0%), milky (n = 2; 10.0%), or green (n = 2; 10.0%), but mainly clear serous (n = 13; 65.0%).
Discussion
The comparison of different diagnostic tools for evaluation of unilateral or bilateral nipple discharge showed varying results for sensitivity and specificity (Table 1). The highest diagnostic value has ultrasonography with 76.5%, followed by galactography with 60.0%, ductoscopy with 56.3%, and nipple smear with only 33.3%. The analysis of the tests in our study demonstrates that ductoscopy, compared with the other 3 methods, leads to satisfactory results, although at this point and on the
Conclusions
The evaluation of ductoscopy compared with other standard diagnostics highlights the method’s diagnostic advantages compared with galactography. However, no current advantage was found in comparison to breast ultrasonography. Definitive conclusions regarding the advantages and disadvantages of ductoscopy mandate additional studies of all diagnostic modalities. Combining ultrasonography with ductoscopy and endoscopic biopsy as routine for nipple discharge could allow for reduction of the number
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