BACKGROUND: The Japanese Association of Mammary Ductoscopy proposed a classification system based on the objective endoscopic appearance of intraductal lesions. This system includes four categories: solitary polypoid, multiple polypoid, superficial, and combined type. However, previous studies did not adequately compare endoscopic findings with histological findings and the prognosis. PATIENTS AND METHODS: One hundred and ten patients with nipple discharge who had intraductal tumors were identified by mammary ductoscopy, and 25 breast cancer patients were identified from our database of records between 2001 and 2008. The clinicopathological data and outcomes of these patients were then reviewed. RESULTS: Lesions in 25 breast cancer patients comprised 12 polypoid solitary type, 3 polypoid multiple type, 5 superficial type, and 5 combined type. Polypoid type showed a low sensitivity on cytological analysis (5 malignant and 10 benign). On the contrary, superficial or combined type showed a high sensitivity (4 malignant and 1 benign). Furthermore, invasive ductal carcinoma was frequently found in the solitary polypoid type. Actuarial disease-free survival for all patients at 10 years was 78%. The estrogen/progesterone receptor status and endoscopic appearance did not significantly affect disease-free survival (DFS), while there was a significant difference in DFS between ductal carcinoma in situ and invasive ductal carcinoma. CONCLUSION: Ductoscopy is a useful procedure for guiding subsequent breast surgery in the treatment of nipple discharge, and the appearance may be essential in treating breast cancer patients with nipple discharge.
BACKGROUND: The Japanese Association of Mammary Ductoscopy proposed a classification system based on the objective endoscopic appearance of intraductal lesions. This system includes four categories: solitary polypoid, multiple polypoid, superficial, and combined type. However, previous studies did not adequately compare endoscopic findings with histological findings and the prognosis. PATIENTS AND METHODS: One hundred and ten patients with nipple discharge who had intraductal tumors were identified by mammary ductoscopy, and 25 breast cancerpatients were identified from our database of records between 2001 and 2008. The clinicopathological data and outcomes of these patients were then reviewed. RESULTS: Lesions in 25 breast cancerpatients comprised 12 polypoid solitary type, 3 polypoid multiple type, 5 superficial type, and 5 combined type. Polypoid type showed a low sensitivity on cytological analysis (5 malignant and 10 benign). On the contrary, superficial or combined type showed a high sensitivity (4 malignant and 1 benign). Furthermore, invasive ductal carcinoma was frequently found in the solitary polypoid type. Actuarial disease-free survival for all patients at 10 years was 78%. The estrogen/progesterone receptor status and endoscopic appearance did not significantly affect disease-free survival (DFS), while there was a significant difference in DFS between ductal carcinoma in situ and invasive ductal carcinoma. CONCLUSION: Ductoscopy is a useful procedure for guiding subsequent breast surgery in the treatment of nipple discharge, and the appearance may be essential in treating breast cancerpatients with nipple discharge.