RT Book, Section
A1 Kim, Julian
A2 Kuerer, Henry M.
SR Print(0)
ID 6414096
T1 Chapter 58. Endoscopy for Nipple Discharge
T2 Kuerer's Breast Surgical Oncology
YR 2010
FD 2010
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-160178-8
LK accesssurgery.mhmedical.com/content.aspx?aid=6414096
RD 2024/04/19
AB The  development  of  microendoscopes  for  visualization  of  mammary  ductal  anatomy  has  progressed  rapidly  over  the  past  2  decades.  The  first  published  reports  of  mammary  ductoscopy  appeared  in  1991  authored  by  Okazaki  et  al  as  well  as  Makita  et  al  in  which  the  endoscopy  was  performed  with  essentially  a  bare  fiberoptic  cord  with  no  working  channel  for  insufflation  or  aspiration.1,2  Subsequently,  Susan  Love  published  a  small  series  of  breast  endoscopy  in  9  patients  with  a  diagnosis  of  ductal  carcinoma  in  situ  at  the  time  of  mastectomy.3  Again,  using  an  early  generation  instrument,  they  encountered  difficulties  with  insufflation  of  the  ducts  and  navigation  of  ductal  branches  due  to  rigidity  of  the  scope.  As  technology  improved,  a  number  of  semiflexible  microendoscopes  emerged,  which  allowed  insufflation  via  a  working  channel  that  was  formed  by  a  sheath  that  surrounded  the  fiberoptic  core.  Reports  of  the  feasibility  of  visualization  and  navigation  to  the  level  of  the  terminal  ductal  lobular  units  were  generated  initially  in  human  mastectomy  specimens  and  subsequently  in  patients  under  local  anesthesia.4,5  These  technologic  developments  resulted  in  visualization  of  submillimeter  intraductal  lesions  and  access  into  the  terminal  human  mammary  ducts,  which  has  spawned  a  new  era  of  intraductal  approaches  to  diagnosis  and  treatment  of  breast  diseases.