Comparative analysis of minimally invasive Microductectomy versus Major Duct Excision in the diagnosis and treatment of patients with pathologic nipple discharge

Abstract

Objective: The present study is a comparison of results in patients with pathological nipple discharge (PND) who underwent microductectomy and those who underwent major duct excision (MDE). Methods:This study included patients who underwent surgery in the clinic due to PND between October 2015 and October 2011. Data were collected via retrospective chart review. The patients were divided into 2 groups according to the type of surgery (Group Micro and Group Major). The demographic characteristics of the patients, the character of the discharge, preoperative imaging findings, preoperative cytological findings, postoperative pathological findings, and follow-up results were analyzed. Results:The records of a total of 78 patients were examined. Group Micro comprised 57 patients, and 21 were included in Group Major. The most frequently observed lesion in both groups was papillomatous lesion without atypia (Group Major: n=8, 38.1% and Group Micro: n=26, 45.6%). Premalignant lesion was detected in 17 patients (atypical ductal hyperplasia, papillomatous lesion with atypia, ductal carcinoma in situ, intraductal papillary carcinoma). Although the number of patients with a premalignant lesion in Group Major was greater than that seen in Group Minor, the difference was not significant (n=11, 19.3% and n=6, 28.6%, respectively; p=0.3). Conclusion:Conventional imaging and cytology techniques are usually insufficient in the diagnosis of PND. Therefore, surgery is frequently required in these patients. Microductectomy or MDE may be selected as the preferred surgical procedure. In this study, the results of the 2 procedures were found to be similar.