Ductoscopy procedure

The ductoscope is usually inserted through the breast, takes a relatively short time, and usually no anesthesia is given. Although the process is short, it is still a bit painful. During the examination, the patient's changes need to be observed at all times. Stop immediately if you feel any discomfort and wipe off the secretions during examination. This method can be used to detect many diseases, especially infections, which are relatively common.

Duct endoscopy is a procedure in which an endoscope with a diameter of 0.75mm (0.6mm or 0.95mm) is inserted into the opening of the mammary duct and the end of the mammary duct is probed toward the end while observing the situation inside the mammary duct through a medical monitor. The farthest that can be reached is the fourth or fifth duct branch. The entire examination process takes about 10 to 15 minutes. No local anesthetic injection is required and the patient does not feel any pain or discomfort.

The ultrafine duct endoscope is composed of an ultrafine optical fiber image bundle, a light guide, a tiny self-focusing mirror and a lens. Through the ultrafine duct endoscope examination, the condition of the breast duct wall and the ductal secretions can be clearly observed. If there is a space-occupying lesion, its color, size, shape, smoothness, etc. can be described.

Breast ductal carcinoma, intraductal papilloma, and ductal inflammation each have their own characteristic ductal endoscopic manifestations, and thus a diagnosis can be made based on this. Another function of the duct endoscope is to perform a biopsy of the lesion under the guidance of the duct endoscope to obtain a pathological diagnosis; to mark the lesion on the skin surface or to accurately locate the surgery by placing a positioning guide wire under the duct endoscope; and to treat benign diseases in the milk duct through the duct endoscope.

Abnormal results

1. For patients with various nipple discharges, especially those with bloody or yellow discharges, the incidence of tumorous lesions in the milk ducts is about 1/3 to 1/2. In addition, many patients with white discharges are also caused by tumors in the milk ducts, and all of them need surgical treatment after ductoscopy.

2. Tumors in the areola area with nipple discharge. Most tumors in this area are intraductal tumors or fibroadenomas, which are closely related to the milk ducts. Ductoscopy can identify the diseased milk ducts, thereby guiding the surgery to accurately remove the tumor and the diseased milk ducts, reducing the chance of local recurrence after surgery;

3. Patients with plasma cell mastitis around the areola. Plasma cell mastitis is caused by proximal plugging of the milk duct, accumulation of secretions, desquamated cells, and inflammatory cells in the milk duct, resulting in acute and chronic inflammation of the breast. Ductoscopy can irrigate and collect the exfoliated cells in the milk ducts, perform cytological examinations, and confirm the diagnosis. It can also flush and dredge the diseased milk ducts to achieve the purpose of drainage. In addition, if the inflammation is relatively localized, the diseased milk ducts can be identified under the ductoscopy, and the diseased milk ducts and local scar tissue can be surgically removed.

4. Mastodynia is a type of breast hyperplasia, which is partly caused by the blockage of the proximal milk duct, which causes poor drainage and twisting of the distal milk duct. Duct lavage and dredging under a ductoscope can help to clarify the diagnosis and achieve a certain therapeutic effect.

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