Ductoscopy

The Ductoscopy also Galaktoskopie or duct Reflection called, is a minimally invasive method for viewing ( mirroring ) of the milk ducts of the female breast .

Applications

In senology , a sub-discipline of gynecology and surgery , ductoscopy is used to diagnose unclear fluid secretions from the nipple. This secretion can be caused by benign and malignant neoplasms such as papillomas of the milk ducts or breast cancer . Unlike galactography , an additional mammographic procedure , ductoscopy allows you to view the milk duct directly from the inside and thus detect even the smallest changes.

execution

After the area has been visualized by means of ultrasound , a secretion is triggered by pressure under general or local anesthesia , the milk duct in question is probed and slightly expanded. A semi-flexible ductoscope can then be inserted through a sleeve while filling the milk duct with physiological saline solution . The instrument has a length of 7.5 to 9.5 cm, so that the milk duct with its branches can be examined up to this length. If there are any abnormalities, cytological smears or targeted biopsies can be obtained.

history

The ductoscopy method was first published in 1988 by M. Teboul, a French radiologist , and has been continuously developed since then. In 1995 a working group at the Ruprecht-Karls-Universität Heidelberg began to dedicate itself to the method in Germany as well. In 1999 ductoscopy was firmly established and clinically used at the Ernst Moritz Arndt University of Greifswald , as the first institution in Germany, under the leadership of Ralf Ohlinger.

literature

U. Euler, S. Paepke, M. Kiechle, H. Schaaf, VR Jacobs: From diagnostic to interventional ductoscopy. Poster at the 80th BGGF conference, Miesbach May 2006. ( online ; PDF document; 147 kB)
R. Ohlinger, S. Grunwald: Duktoskopie - teaching atlas for endoscopic milk duct mirroring. Walter de Gruyter, Berlin 2009, ISBN 978-3-11-020643-2 .
VR Jacobs, S. Paepkea, S. Grunwald, R. Ohlinger, M. Kiechle-Bahata: Breast Ductoscopy: Technical Development from a Diagnostic to an Interventional Procedure and Its Future Perspective. In: Oncology. 30, 2007, pp. 545-549. doi: 10.1159 / 000108283
WC Dooley: Breast ductoscopy and the evolution of the intra-ductal approach to breast cancer. In: Breast J. 15, 2009, Suppl 1, pp. S90-S94. PMID 19775336
WC Dooley: Ductoscopy and the intra-ductal approach to breast cancer. Elsevier Health Sciences, 2006, ISBN 0-7020-2738-3 (English, limited preview in Google Book Search).
S. Grunwald, H. Heyer, S. Paepke, G. Schwesinger, A. Schimming, M. Hahn, A. Thomas, VR Jacobs, R. Ohlinger: Diagnostic Value of Ductoscopy in the Diagnosis of Nipple Discharge and Intraductal Proliferations in Comparison to Standard Methods. In: Oncology. 30 (2007), pp. 243-248. doi: 10.1159 / 000100848
K. Uchida, H. Fukushima, Y. Toriumi, K. Kawase, I. Tabei, A. Yamashita, H. Nogi: Mammary ductoscopy: current issues and perspectives. In: Breast Cancer. 16, 2009, pp. 93-96. doi: 10.1007 / s12282-008-0083-7
S. Paepke, VR Jacobs, R. Ohlinger, S. Grunwald, M. Warm, M. Hahn, M. Kiechle-Bahat: Possibilities of milk duct endoscopy - deep look into the breast. In: In Focus Oncology. 7-8, 2007, pp. 56-57. ( online ; PDF document; 107 kB)

Individual evidence

↑ M. Teboul: A new concept in breast investigation: echo-histological acino-ductal analysis or analytic echography. In: Biomed Pharmacother . 42, 1988, pp. 289-295. PMID 3056535 .
↑ T. Kamio, S. Kameoka, H. Muraki, H. Kanzaki, H. Shindo, T. Kato, A. Fujii, K. Yamamoto, T. Kimura, K. Hamano: Significance of ductal findings in ultrasonic examination of the breast: diagnosis of intraductal tumor and intraductal spreading of breast cancer. In: F. Kasumi, E. Ueno (Eds.): Topics in Breast Ultrasound. Seventh International Congress on the Ultrasonic Examination of the Breast. Shinohara, Tokyo 1991, pp. 200-205.
↑ A. Okazaki, M. Okazaki, K. Asaishi, H. Satoh, Y. Watanabe, T. Mikami, Y. Okazaki, K. Nabeta, K. Hirata: Fiberoptic ductoscopy of the breast: a new diagnostic procedure for nipple discharge . In: Japanese Journal of Clinical Oncology . 21, 1991, pp. 188-193.
↑ B. Pereira, K. Mobkel: Mammary ductoscopy: past, present and future. In: Int J Clin Oncol 10 2005, pp. 112-116.
↑ D. Wallwiener: Preface In: R. Ohlinger, S. Grunwald: Duktoskopie - teaching atlas for endoscopic milk duct mirroring. Walter de Gruyter, Berlin 2009, ISBN 978-3-11-020643-2 .

[1] M. Teboul: A new concept in breast investigation: echo-histological acino-ductal analysis or analytic echography. In: Biomed Pharmacother . 42, 1988, pp. 289-295. PMID 3056535 .

[2] T. Kamio, S. Kameoka, H. Muraki, H. Kanzaki, H. Shindo, T. Kato, A. Fujii, K. Yamamoto, T. Kimura, K. Hamano: Significance of ductal findings in ultrasonic examination of the breast: diagnosis of intraductal tumor and intraductal spreading of breast cancer. In: F. Kasumi, E. Ueno (Eds.): Topics in Breast Ultrasound. Seventh International Congress on the Ultrasonic Examination of the Breast. Shinohara, Tokyo 1991, pp. 200-205.

[3] A. Okazaki, M. Okazaki, K. Asaishi, H. Satoh, Y. Watanabe, T. Mikami, Y. Okazaki, K. Nabeta, K. Hirata: Fiberoptic ductoscopy of the breast: a new diagnostic procedure for nipple discharge . In: Japanese Journal of Clinical Oncology . 21, 1991, pp. 188-193.

[4] B. Pereira, K. Mobkel: Mammary ductoscopy: past, present and future. In: Int J Clin Oncol 10 2005, pp. 112-116.

[5] D. Wallwiener: Preface In: R. Ohlinger, S. Grunwald: Duktoskopie - teaching atlas for endoscopic milk duct mirroring. Walter de Gruyter, Berlin 2009, ISBN 978-3-11-020643-2 .