Ductoscopy May Aid Diagnosis of Nipple Discharge.

SAN ANTONIO -- Mammary fiberoptic ductoscopy is a useful emerging technique in the diagnosis of pathologic nipple discharge, Dr. Jill R. Dietz said at a breast cancer symposium sponsored by the San Antonio Cancer Institute.

Breast cancer frequently arises in the milk ducts. Direct visualization into the distal ductal system often detects malignant or premalignant lesions deep inside that went unsuspected upon mammography and ductography, explained Dr. Dietz, a surgeon at the Cleveland Clinic Foundation.

Ductoscopy is also of value in directing surgical excision of the pathologic duct. It enables the surgeon to take far less tissue while ensuring that the target lesion has actually been removed.

Many women who've undergone conventional ductal surgery for pathologic nipple discharge are unable to breast-feed thereafter. Dr. Dietz believes that ductoscopy-guided minimally invasive surgery will allow most of her patients to breast-feed, although she doesn't yet have sufficient patient numbers to prove it.

She presented a phase I study in which intraoperative ductoscopy using an Acueity 1.2-mm semirigid fiberoptic ducto- scope was attempted in 51 conscious patients with pathologic nipple ...