The lactoscopy system includes fiberscope, camera system, cold light source system, display system and computer-controlled recording system, which is feasible to collect static and dynamic image records in real time. Our hospital currently introduces the German Scherer lactoscopy system, which is capable of carrying out various lactoscopic examinations and treatment measures. As a tool for diagnosing the cause of nipple overflow, ductoscopy has its unique advantages of being easy to operate, less invasive and intuitive, effectively improving the diagnosis rate of augmented lesions in the milk ducts, and also being used for the treatment of benign milk duct lesions, such as ductoscopy-assisted minimally invasive excision of diseased milk ducts, treatment of plasmacytoid mastitis, diagnosis and treatment of breast pain, etc.
The significance of breast ductoscopy is.
1, clarify the etiology of nipple overflow;
2. Refine the indications for surgery and reduce unnecessary surgery;
3.Reduces the scope of surgery and removes the lesion accurately;
4.Exploratory treatment can be performed for some special types of diseases;
5.With the help of lactoscopy, some minimally invasive treatment and minimally invasive surgery can be carried out;
Indications for lactoscopy and treatment, nipple overflow
Nipple overflow is one of the common clinical symptoms of breast diseases. About 10% of women can be found to have nipple overflow during routine physical examination, and about 35% to 50% of them have intra-ductal papilloma and papillomatosis. In the past, the main methods of examination for nipple discharge were cytologic smear, selective mammography and ultrasound, but their diagnostic rates were not high at 50% to 80%, not intuitive and difficult to localize the lesion. A variety of benign and malignant diseases of the breast can manifest as nipple discharge, such as lobular hyperplasia, ductal dilatation, milk retention, intraductal papilloma or intraductal papillomatosis, and breast cancer (early breast cancer including intraductal carcinoma and lobular carcinoma in situ), among which intraductal papillomatosis is also a pre-cancerous lesion of the breast. Clinical diagnosis of nipple overflow is a prerequisite for further treatment. Ductal endoscopy not only greatly improves the diagnostic accuracy of the cause of nipple overflow and enables patients to avoid unnecessary surgery, but also overcomes the shortcomings of mammography and other conventional examinations that are difficult to confirm the diagnosis. In patients with nipple overflow, if a mass is found under the ductoscope, it can be accurately localized and surgically removed with minimal trauma under the guidance of the ductoscope.
What conditions require lactoscopy and treatment?
Patients with nipple overflow of various colors, especially bloody overflow and yellow overflow, have an incidence of tumor lesions in the milk ducts of about 1/3 to 1/2, and there are many cases of white overflow due to masses in the milk ducts, all of which require surgical treatment;
Most of the masses in this area are intraductal tumors or fibroadenomas, which are closely related to the milk ducts, and the diseased milk ducts can be clearly identified through ductoscopy, thus guiding the surgery to accurately remove the masses and diseased milk ducts and reduce the chance of local recurrence after surgery;
Patients with plasmacytoid mastitis in the areola area and around the areola, plasmacytoid mastitis is caused by the proximal plugging of the milk ducts and the accumulation of secretions, exfoliated cells, and inflammatory cells in the milk ducts, resulting in acute and chronic inflammation of the breast, and ductoscopy can irrigate and collect exfoliated cells in the milk ducts for cytological examination to clarify the diagnosis; at the same time, it can also flush and unblock the diseased milk ducts to achieve the purpose of drainage; in addition, if In addition, if the inflammation is limited, the diseased milk ducts can be clearly identified under lactoscopy, and the diseased milk ducts and local scar tissue can be surgically removed;
4, patients with breast pain, a type of breast hyperplasia, partly due to blockage of the proximal milk ducts, so that the distal milk ducts do not drain smoothly, twisting and bending, lavage of the milk ducts under lactoscopy, to help clarify the diagnosis, and is expected to achieve a certain therapeutic effect;
5.Patients with cumulative breast cysts can improve their symptoms after draining the milk ducts.
Current lactoscopic treatment items
1, lavage of milk ducts, cytological examination, clear diagnosis, and can achieve certain therapeutic effect;
2, Plasmacytoid mastitis and other diseases, lesion duct irrigation, and injection of antibiotics and other drugs;
3, the use of ductoscopic mesh basket to remove large pieces of flocculent material or unblock the milk ducts;
4.Use of ductoscopic biopsy forceps for biopsy of suspicious lesions;
5.Lactoscopic crochet to locate neoplastic lesions and remove them accurately;
6.Lactoscopy assisted minimally invasive excision of diseased milk ducts.