New technique lets doctors examine milk ducts for breast problems.(ductoscopy)

2002 DEC 5 - (NewsRx.com & NewsRx.net) -- A new technique enables doctors to directly examine the lining of milk ducts in the breast for early signs of cancer and other abnormalities, according to research at Washington University School of Medicine in St. Louis.

The researchers used the technique, known as ductoscopy, to detect breast abnormalities in women with a condition called pathologic nipple discharge (PND).

"This technique is more successful than anything we've had in the past for identifying and localizing abnormalities in the breast in women with pathologic nipple discharge," said first author Jill Richardson Dietz, MD, assistant professor of surgery and a breast surgeon at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital. "Ductoscopy helps the surgeon find the lesion, take it out and save normal breast tissue."

According to Dietz, the technique also may help surgeons detect and treat breast cancer - more than 80% of which arises in milk ducts.

PND is a clearish bloody discharge from a milk duct. Only a small percentage of women experience the problem, and fewer than 5% of those show signs of cancer. Most often, PND is caused by benign changes such as the growth of tiny polyps, known as papillomas, in the ducts.

Doctors traditionally treat the condition by surgically removing the ductal system that is releasing the fluid, but it often is difficult to locate the abnormal tissue within the breast. For example, ductograms, flat, 2-dimensional mammograms that use a dye injected into the duct at the nipple, may not precisely or completely locate abnormalities. Alternatively, surgeons sometimes insert a fine fiber-like probe into the problem duct and remove the tissue around the probe, or they may remove all the ducts behind the nipple.

These procedures often require an educated guess about the location of unhealthy tissue within the breast and often result in removal of a relatively large amount of healthy tissue as well (Dietz JR, Crowe JP, ...