caa a22 4500 445338806 CHVBK 20180317142805.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1791-3 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1791-3 Office Ductoscopy for Surgical Selection in Women with Pathologic Nipple Discharge [Elektronische Daten] [Seema Khan, Amrit Mangat, Aeisha Rivers, Elizabeth Revesz, Barbara Susnik, Nora Hansen] Background: Pathologic nipple discharge (PND) is diagnosed clinically and managed by diagnostic duct excision (DDE). Mammary ductoscopy in the office setting may change this standard. We performed a prospective study to assess the utility of office ductoscopy for surgical selection in women with nipple discharge. Methods: Women with nipple discharge meeting at least 2 of 3 criteria of PND (spontaneous, single duct, bloody or serous) underwent office ductoscopy. Those showing papillomatous lesions underwent DDE in the operating room (surgical group, n=38); if no lesion was present, women were followed clinically (observation group, n=21). Results: A papillomatous lesion was identified in 79% of women with 3-criteria PND and in 21% with 2 criteria (P=.001). DDE yielded a proliferative lesion in 35 of 38 women (92%). Of the 38, 27 (71%) had papillomata, 2 (5%) had florid hyperplasia, and 6 (16%) had ductal carcinoma in situ (DCIS) on final pathology. Also, 11 women with papilloma and 1 with DCIS presented with 2-criteria PND. Ductoscopy findings were a better predictor of the presence of intraductal neoplasia (area under curve [AUC] 0.9, 95% confidence interval [95% CI] 0.8-0.98) compared with 3-criteria PND (AUC 0.7, 95% CI 0.6-0.8). The 21 women in the observation group did not develop signs of malignancy or need biopsy during a 48-month follow-up period. Conclusions: Our findings suggest that office ductoscopy provides accurate surgical selection of women with nipple discharge and should be considered for women with 2 criteria of PND, and those with negative ductoscopy can be safely observed. These findings need confirmation in a larger study with longer follow-up. Society of Surgical Oncology, 2011 Khan Seema Department of Surgery, Lynn Sage Breast Center, Northwestern Feinberg School of Medicine, Chicago, IL, USA aut Mangat Amrit Department of Surgery, Lynn Sage Breast Center, Northwestern Feinberg School of Medicine, Chicago, IL, USA aut Rivers Aeisha Beaumont Breast Center, Beaumont Hospital, Royal Oak, MI, USA aut Revesz Elizabeth Department of Surgery, Lynn Sage Breast Center, Northwestern Feinberg School of Medicine, Chicago, IL, USA aut Susnik Barbara Pathology Laboratory, Abbott Northwestern Hospital, Minneapolis, MN, USA aut Hansen Nora Robert H. Lurie Cancer Center, Northwestern Feinberg School of Medicine, Chicago, IL, USA aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3785-3790 1068-9265 18:13<3785 2011 18 10434 https://doi.org/10.1245/s10434-011-1791-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1791-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Khan Seema Department of Surgery, Lynn Sage Breast Center, Northwestern Feinberg School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 700 1- Mangat Amrit Department of Surgery, Lynn Sage Breast Center, Northwestern Feinberg School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 700 1- Rivers Aeisha Beaumont Breast Center, Beaumont Hospital, Royal Oak, MI, USA aut NATIONALLICENCE 700 1- Revesz Elizabeth Department of Surgery, Lynn Sage Breast Center, Northwestern Feinberg School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 700 1- Susnik Barbara Pathology Laboratory, Abbott Northwestern Hospital, Minneapolis, MN, USA aut NATIONALLICENCE 700 1- Hansen Nora Robert H. Lurie Cancer Center, Northwestern Feinberg School of Medicine, Chicago, IL, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3785-3790 1068-9265 18:13<3785 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer