The new procedure of micro endoscopic ductoscopy is a feasible diagnostic method for visual inspection of the breast ducts through a camera, that provides surgeons direct access to the ductal epithelium. Its increasing importance in the diagnosis of intraductal anomalies in case of pathologic nipple discharge is especially significant for patients that have negative conventional imagery for breast cancer.
Pathologic nipple discharge (PND) is one of three most common breast related complains in women, that is often associated with breast cancer. Although the causes of PND are in most cases benign, currently used screening methods such as mammogram, ultrasound or MRI are not always able to proof the cause of the disease.
Due to the high-test sensitivity and specificity, ductoscopy not only outperforms most currently used imaging techniques, but also prevents the need for invasive surgery that can cause infection and breastfeeding problems. Ductoscopic guided excision is an improvement over standard surgical approaches with terminal duct excision, during which large volume of breast tissue is removed.
Ductoscope is a device allowing direct visualization of any abnormalities within the ductal system, which is inserted into the ducts of the breast via nipple oriffice. The device is used to identify and diagnose very small lesions, that often cannot be yet detected by mammography, ultrasound or other commonly used screening methods. Ductoscopy procedure has a short and relatively easy learning curve ensuring correct use and ability to recognize and comment on the images obtained during examination.
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After disinfection and surface or local infiltration anesthesia of the areola, the tip of the ductoscope is inserted into breast milk duct, that is subsequently dilated using saline. Then, the duct is assessed under video guidance. The new scope with small diameter adapts perfectly without causing irritation or interfering in any way with the inside of the breast.
After evaluation of the main ducts, surgeon proceeds to the side ducts that are being examined until further advancement is no longer possible due to the size of the inserted micro-endoscope. When the ducts of interest are inspected, the instrument is extracted, and the procedure is finished.
This set up also allows the usage of 3-wire basket and/or laser wire for minimal invasive procedure. Therefore, in case of any findings, the 3-wire is easily inserted into the milk duct around papilloma, which is immediately extracted under direct visualization. The obtained tissue is removed from the duct and sent for confirming pathological analysis.
This procedure does not require general anesthesia or any preliminary preparations, thus the diagnostic exploration and possible biopsy or minimally invasive surgery can be carried out instantly at the outpatient clinic. This makes ductoscopy a cost-effective treatment.
Conventional examination methods such as mammography, ultrasound or MRI, might not always find the cause of the problem patient is suffering from. Examination carried out by ductoscope is exact, contributes to more precise local resection and may also help to fully avoid surgeries in women with endoscopically normal ducts for benign causes.
The procedure allows direct visualization of the mammary ducts using sub-millimeter fiberoptic micro endoscope inserted through the ductal opening into the nipple surface, which enables real-time observation of the milk ducts of the breast. The scope magnifies the examined duct up to 60 times its normal size, resulting in obtaining good images.
Studies have shown that ductoscopy does not seem to impact quality of life of patients over time due to the ability of precisely locating intraductal lesions and providing a guidance during excision. In comparison with other commonly used examining and surgical techniques, patients do not patients do not experience breast tissue scarring, nor are they exposed to radiation during examination.
Ductoscopy is minimally invasive micro-endoscopic technique allowing accurate visualization, analysis and excision of intraductal abnormalities. Lesions are located precisely, regardless of the depth of their occurrence. Therefore the surgery is performed without any unnecessary tissue damage ensuring patient’s quick recovery.
Are you interested in helping your patient with this minimal invasive treatment? Get in touch with us and we will be happy to answer any of your questions regarding the Ductoscope and the procedure.
Leander Healthcare B.V.
Tel: +31 (0) 30 755 53 80
Mail: info@leanderhealthcare.com
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3452 MT Vleuten
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