Get access

Feasibility and Technical Considerations of Mammary Ductoscopy in Human Mastectomy Specimens

Authors

  • Jill R. Dietz MD,

    1. Department of General Surgery, Cleveland Clinic Breast Center and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, Ohio
    Search for more papers by this author
  • Julian A. Kim MD,

    1. Department of General Surgery, Cleveland Clinic Breast Center and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, Ohio
    Search for more papers by this author
  • Jan L. Malycky BA,

    1. Department of General Surgery, Cleveland Clinic Breast Center and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, Ohio
    Search for more papers by this author
  • Lawrence Levy MD,

    1. Department of General Surgery, Cleveland Clinic Breast Center and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, Ohio
    Search for more papers by this author
  • Joseph Crowe MD

    1. Department of General Surgery, Cleveland Clinic Breast Center and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, Ohio
    Search for more papers by this author

Address correspondence and reprint requests to: Jill R. Dietz, MD, Desk A80, Department of General Surgery, 9500 Euclid Ave., Cleveland, OH 44195, U.S.A., or e-mail: dietzj@ccf.org

Abstract

Abstract: Recent advances in endoscopic technology have made visualization of human mammary ducts possible. The purpose of this study was to assess the feasibility and technical factors influencing the ability to successfully visualize the epithelium of the human mammary ductal system. Lacrimal duct probes were used to dilate nipple orifices to 1.2 mm on 42 mastectomy specimens. The Depth of Field Imaging Micro-Minimally Invasive (DOFI® MMI) system consisting of a 1.2 mm rigid ductoscope with a 350 μm working channel was introduced into mammary ducts under air insufflation or saline irrigation. At least one major duct could be dilated and cannulated in all 42 specimens. Visualization of the proximal duct was accomplished in 34 of 42 (81%) specimens, whereas more extensive navigation through the distal subsegmental ducts was achieved in 22 of 42 (52%) specimens. Ductoscopy into the terminal ducts was accomplished in all patients with a previous history of nipple discharge or discharge at the time of the procedure (10 of 10). In three patients with no history of nipple discharge prior to ductoscopy, incidental papillomas were discovered and confirmed by the pathologist. In conclusion, mammary ductoscopy is technically feasible and may have an application as an additional diagnostic modality for patients with pathologic nipple discharge.

Ancillary