- William C Dooley, MD, FACS
William C Dooley, MD, FACS
- Professor of Surgery
- The University of Oklahoma College of Medicine
- Section Editor
- Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
- Section Editor — Breast Surgery
- Associate Professor, Department of Surgery
- Yale University School of Medicine
Mammary ductoscopy is an endoscopic technique that allows for direct visualization and sampling of intraductal lesions [1-7]. Ductoscopy has been used more widely in breast surgery in Asia with the advent of durable submillimeter endoscopes and duct distention techniques. However, ductoscopy is not commonly performed in the United States [8-16].
In this topic, we discuss the use of ductoscopy to diagnose and treat conditions such as pathologic nipple discharge and early-stage breast cancer. Other aspects of nipple discharge are discussed elsewhere. (See "Nipple discharge" and "Surgical management of pathologic nipple discharge".)
Ductoscopy provides a way to directly visualize and sample or excise lesions in the mammary ducts. The indications for performing a ductoscopy include:
●Pathologic nipple discharge from a single duct orifice (bloody or high-volume clear fluid)
●Known breast lesions (atypical ductal hyperplasia [ADH], ductal carcinoma in situ [DCIS], or invasive cancer) with expressible nipple fluidTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- Pathologic nipple discharge
- Early-stage breast cancer with expressible nipple fluid
- Prior nipple surgery
- Multiduct or nonreproducible discharge
- PREOPERATIVE EVALUATION AND PREPARATION
- Preoperative imaging
- Preoperative hydration
- SURGICAL ANATOMY
- OPERATIVE MANAGEMENT
- Initial steps
- Subsequent steps
- - Pathologic nipple discharge
- Multiple lesions
- - Early-stage breast cancer
- Alternative (Asian) technique
- PATHOLOGIC EVALUATION
- POSTOPERATIVE CARE
- SUMMARY AND RECOMMENDATIONS