Patients With Pathological Nipple Discharge:Preoperative Ductoscopy Can More Effectively Evaluate The Detection Of Early Occult Breast Cancer

Objective: Nipple discharge is often an early symptom of intraductal diseases,including cystic hyperplasia of the breast,intraductal papilloma,duct ectasia,and breast cancer.Here,we compared the diagnostic value of ductoscopy with that of ultrasonography and mammography for the preoperative evaluation of breast cancer in patients with nipple discharge as the earliest presenting symptom.Methods: Clinical data of 410 patients with pathological nipple discharge who received surgical treatment in our hospital were retrospectively analyzed.All patients received ductoscopy,ultrasound,and mammography before surgery.Results: Pathological diagnosis was achieved for all patients.A total of 445 lesions were removed surgically,including 414 benign lesions(93.03%)and 31 malignant lesions(6.97%).Among the malignant lesions,there were 20 cases of intraductal carcinoma in situ(DCIS).Ductoscopy showed significantly higher sensitivity for the preoperative evaluation of breast cancer than ultrasound and mammography(90.32% vs.61.29% and48.39%).The sensitivity of ductoscopy combined with ultrasound and mammography was 93.55%.The sensitivity of conventional ultrasound combined with mammography was 70.97%.Conclusion: Ductoscopy is more sensitive than ultrasound and mammography for the diagnosis of malignant breast tumors,especially DCIS,in patients with pathological nipple discharge.It is also more effective in locating lesions within the breast ducts and determining their characteristics,which facilitates precise surgical removal.Therefore,we recommend that ductoscopy should be performed together with routine examinations such as breast ultrasound and mammography to improve the diagnosis of patients with nipple discharge.