Scarless Endoscopic Papillomectomy of the Breast

Bender, Ömer; Balcı, Fatih Levent; Yüney, Enis; Akbulut, Hasan

doi:10.1159/000195694

Cited by 22 publications

(32 citation statements)

References 21 publications

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“…As mucosal wounds heal with reduced scar formation when compared with skin, 26 when possible there should be consideration of endoscopic surgical technique 37 …”

Section: Scarless Wound‐healing Physiologymentioning

confidence: 99%

Strategies for prevention of scars: what can we learn from fetal skin?

2010

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Fetal wound healing occurs rapidly and without scar formation early in gestation.Studying the mechanisms of scarless repair can lead to novel scar-preventive approaches. In fetal wounds, collagen is deposited early and is fine and reticular with less cross-linking. Several important differences of fetal vs. postgestational wound-healing response have been determined, such as the presence of less inflammation, higher hyaluronic acid concentration and a greater ratio of collagen type III to type I. Compared with typical wounds, there are also altered ratios of signaling molecules, such as higher ratios of transforming growth factor (TGF)-b3 to TGF-b1 and -b2, and matrix metalloproteinases to tissue inhibitors of metalloproteinases. Furthermore, fetal fibroblasts do not exhibit TGF-b1-induced collagen production compared with their mature counterparts.Patterning genes (homeobox genes) involved in organogenesis are more active in the fetal period and are believed to be the ''first domino'' in the fetal cutaneous wound repair regulatory cascade. The recommended scar-preventive agents, such as Scarguard MD â , silicone gel and sheet, Seprafilm â Bioresorbable Membrane, topical hyaluronan, onion extract, oral tamoxifen and 585-nm pulsed dye laser are reviewed in this study. Despite the lack of supporting evidence, there is a widespread false presumption that the acceleration of healing with the widely assumed scar-preventive commercial agents is associated with decreased scar formation. Humans are erroneously inclined to make a negative correlation between the healing rate and the degree of scar formation, while such a correlation does not exist in reality. Despite the importance of scar prevention, no FDA-approved therapy for this purpose is available in the 21st century, which reflects the important challenges, such as the presence of redundant pathways, that these approaches are facing.

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“…As mucosal wounds heal with reduced scar formation when compared with skin, 26 when possible there should be consideration of endoscopic surgical technique 37 …”

Section: Scarless Wound‐healing Physiologymentioning

confidence: 99%

Strategies for prevention of scars: what can we learn from fetal skin?

2010

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“…Ductoscopy is more than a mere diagnostic tool because it may, e.g. in the treatment of solitary papillomas, permit targeted intraductal excision instead of more radical surgery [8,9,10,11]. …”

Section: Introductionmentioning

confidence: 99%

Nipple Discharge: Role of Ductoscopy in Comparison with Standard Diagnostic Tests

Albrecht

Thele²,

Grunwald³

et al. 2013

Oncol Res Treat

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Background: This study aims to assess the role of ductoscopy for detecting intraductal anomalies in patients with nipple discharge in comparison to conventional tests and to find an effective combination of both approaches. Materials and Methods: Prior to duct excision, ductoscopy was performed in 97 women. Histologic and all other diagnostic results were compared. Sensitivity, specificity, and efficiency were calculated for all methods. These parameters were also calculated for all possible test combinations in 12 patients who had completed all tests. Results: Breast sonography reached the highest sensitivity (64.1%) and efficiency (64%); mammography had the highest specificity (100%). The sensitivity of ductoscopy was 53.2%, its specificity 60%, and its efficiency 55.1%. Among combinations of all methods, the combination ductoscopy + galactography was the most sensitive (80%). Mammography, magnetic resonance imaging, and ductoscopy were each 100% specific. Ductoscopy was the most efficient (75%) single method. Conclusion: Ductoscopy is a valuable test for diagnosing intraductal lesions in patients with nipple discharge. It is more efficient than conventional tests in patients undergoing all tests.

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“…[38] performed 22 endoscopic papillomectomies among SND patients found to have solitary papillomas at MD and 5 ductoscopy-assisted microdochectomies among patients found to have multiple papillomas. The discharges in all but one patient stopped during a mean follow-up period of 11.5 months, giving endoscopic papillomectomy a therapeutic efficacy of 95.4% (21/22).…”

Section: Treatment Of Pathologic Nipple Discharge With MDmentioning

confidence: 99%

Mammary ductoscopy in the current management of breast disease

et al. 2010

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Duct endoscopes have become smaller in diameter with working channels and improved optical definition. Currently, the role of MD is best defined in the management of SND facilitating targeted surgical excision, potentially avoiding unnecessary surgery, and limiting the extent of surgical resection for benign disease. The role of MD in breast-cancer screening and breast conservation surgery has yet to be fully defined. Few prospective randomized trials exist in the literature, and these would be crucial to validate current opinion, not only in the benign setting but also in breast oncologic surgery.

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Scarless Endoscopic Papillomectomy of the Breast

Cited by 22 publications

References 21 publications

Strategies for prevention of scars: what can we learn from fetal skin?

Strategies for prevention of scars: what can we learn from fetal skin?

Nipple Discharge: Role of Ductoscopy in Comparison with Standard Diagnostic Tests

Mammary ductoscopy in the current management of breast disease

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