Endoskopische Milchgangsspiegelung - Indikationen und praktische Durchführung

Grunwald, S.; Heyer, H.; Paepke, Stefan; Schulz, K.-D.; Öhlinger, R.

doi:10.1055/s-2006-923809

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…Both benign and malignant breast disorders can be associated with ND. Among benign lesions associated with ND, papilloma is especially important: Approximately 50% of patients with a papilloma have ND, and 5-17% of papillomas will eventually turn malignant [4,5,6]. ND is also observed in 0.5-12% of malignant breast lesions, especially in ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) [1,2].…”

Section: Introductionmentioning

confidence: 99%

Ductoscopic Detection of Intraductal Lesions in Cases of Pathologic Nipple Discharge in Comparison with Standard Diagnostics: The German Multicenter Study

et al. 2014

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SummaryBackground: According to the literature, ductoscopy is gaining increasing importance in the diagnosis of intraductal anomalies in cases of pathologic nipple discharge. In a multicenter study, the impact of this method was assessed in comparison with that of standard diagnostics. Patients and Methods: Between 09/2006 and 05/2009, a total of 214 patients from 7 German breast centers were included. All patients underwent elective ductoscopy and subsequent ductal excision because of pathologic nipple discharge. Ductoscopy was compared with the following standard diagnostics: breast sonography, mammography, magnetic resonance imaging (MRI), galactography, cytologic nipple swab, and ductal lavage cytology. The histological and imaging results were compared and contrasted to the results obtained from the nipple swab and cytologic assessment. Results: Sonography had the highest (82.9%) sensitivity, followed by MRI (82.5%), galactography (81.3%), ductoscopy (71.2%), lavage cytology (57.8%), mammography (57.1%), and nipple swab (22.8%). Nipple swabs had the highest (85.5%) specificity, followed by lavage cytology (85.2%), ductoscopy (49.4%), galactography (44.4%), mammography (33.3%), sonography (17.9%), and MRI (11.8%). Conclusion: Currently, ductoscopy provides a direct intraoperative visualization of intraductal lesions. Sensitivity and specificity are similar to those of standard diagnostics. The technique supports selective duct excision, in contrast to the unselective technique according to Urban. Therefore, ductoscopy extends the interventional/diagnostic armamentarium.

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Section: Introductionmentioning

confidence: 99%

Ductoscopic Detection of Intraductal Lesions in Cases of Pathologic Nipple Discharge in Comparison with Standard Diagnostics: The German Multicenter Study

et al. 2014

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Stellenwert der Duktoskopie in der Mammadiagnostik

et al. 2006

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Die Mamillensekretion ist ein häufig assoziiertes Symptom bei Brusterkrankungen, dessen Frequenz in Abhängig-keit vom feingeweblichen Befund mit zwischen 1 und 33 angegeben wird [32]. Das Karzinomrisiko bei Mamillensekretion wird mit 1,3-47 angegeben [9, 40, 45, 59]. Die Sekretion der weiblichen Brustdrüse stellt eine besondere diagnostische und therapeutische Herausforderung dar, denn die Vielzahl der diagnostischen Verfahren (Inspektion, Palpation, Zytologie, Mammographie, Galaktographie, Sonographie einschließlich Duktsonographie, MRT, Duktallavage) lassen nicht immer eine Dignitätsdifferenzierung (maligne vs. benigne) zu. Alle bisher eingesetzten diagnostischen Methoden sind indirekte Verfahren zur Darstellung des Milchgangssystems und seiner intraduktalen Prozesse. Mit der minimal-invasiven endoskopischen Milchgangsspiegelung (Duktoskopie, syn. Galaktoskopie) steht erstmalig eine Methode zur Verfügung, die eine direkte Visualisierung intraduktaler Veränderungen bei pathologischer Sekretion zulässt. Während die anderen Verfahren oft in die "blinde" offene Biopsie mün-den, könnte diese durch eine gezielte Probeentnahme (PE) unter duktoskopischer Sicht bald der Vergangenheit angehören.Die Machbarkeit der Duktoskopie ist grundsätzlich erwiesen, ihr Stellenwert in der Diagnosekette bei einer Mamillensekretion wird derzeit weltweit geprüft. In Deutschland wird sie in den letzten Jahren zunehmend eingesetzt, zunächst aber noch als zusätzliches Diagnostikum auf experimenteller Basis. Der unkritische breite Einsatz dieser neuen Methode kann vor dem Vorliegen valider Ergebnisse im Rahmen von Studien noch nicht empfohlen werden.Während der Schwangerschaft und Stillzeit ist eine klare bzw. milchige Sekretion, meist beidseitig, physiologisch. Außerhalb dieser Zeit ist jede Sekretiongleich ob ein-oder beidseitig, serös oder blutig, spontan oder auf leichten Druckabklärungsbedürftig.

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Diagnostic Value of Ductoscopy in the Diagnosis of Nipple Discharge and Intraductal Proliferations in Comparison to Standard Methods

Grunwald

Heyer²,

Paepke³

et al. 2007

Oncol Res Treat

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Ductoscopy is gaining increased importance in the diagnosis of nipple discharge of unclear origin and intraductal proliferation. For this reason we compared its diagnostic value and feasibility to standard diagnostic methods. Material and Methods: Ductoscopy was compared to mammography, galactography, sonography, magnetic resonance imaging (MRI), nipple smear, fine needle aspiration cytology (FNAC), and high-speed core biopsy; feasibility, sensitivity, and specificity were investigated for each method. Results: 71 ductoscopies were evaluated, which were followed up by open biopsies. Here, 3 invasive and 8 ductal carcinomas in situ were found, as well as 3 atypical ductal hyperplasias, 44 papillomas/papillomatoses, and 13 benign findings. Feasibility of ductoscopy was in this series 100%. Duct sonography showed the highest sensitivity (67.3%), followed by MRI (65.2%), galactography (56.3%), ductoscopy (55.2%), and FNAC (51.9%). The highest specificity was shown by FNAC, core biopsy, and galactography (each 100.0%), followed by mammography (92.3%), nipple smear (77.8%), ductoscopy, and duct sonography (each 61.5%); the lowest specificity was displayed by MRI (25.0%). Conclusion: The results confirm that ductoscopy can be performed within the same range of sensitivity and specificity as other techniques. In order to make conclusive statements about ductoscopy, especially in order to precisely define the indications for this method, a prospective multicenter study was initiated.

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Endoskopische Milchgangsspiegelung - Indikationen und praktische Durchführung

Cited by 3 publications

References 6 publications

Ductoscopic Detection of Intraductal Lesions in Cases of Pathologic Nipple Discharge in Comparison with Standard Diagnostics: The German Multicenter Study

Ductoscopic Detection of Intraductal Lesions in Cases of Pathologic Nipple Discharge in Comparison with Standard Diagnostics: The German Multicenter Study

Stellenwert der Duktoskopie in der Mammadiagnostik

Diagnostic Value of Ductoscopy in the Diagnosis of Nipple Discharge and Intraductal Proliferations in Comparison to Standard Methods

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