Lactoscopy is the first choice for nipple discharge
Ductoscopy, also known as electronic breast fiberoptic endoscopy, has replaced mammography as the preferred means of diagnosing the cause of nipple discharge. It is easy to operate, less invasive and intuitive, and effectively improves the diagnosis rate of augmentation lesions in the ducts, and can also be used for the treatment of benign duct lesions, such as minimally invasive mastectomy, treatment of plasmacytoid mastitis, and localization of tumor guide wires in the ducts.
The following tests are also feasible for nipple overflow to clarify the diagnosis.
I. Cytological examination of the overflow.
1. Advantages.
Overflow cytology is simple, convenient and can detect breast cancer at an early stage, which is an easily acceptable diagnostic method for patients.
2. Disadvantages.
The positivity rate is low.
Needle aspiration cytology of lumps
1.Advantages.
The correct diagnosis rate of breast cancer by needle aspiration cytology can reach 96% in cases of nipple discharge with intramammary lumps.
2. Disadvantages.
The correct diagnosis rate for benign nipple overflow is lower and often needs to be combined with clinical findings and other ancillary examinations for comprehensive consideration.
Biopsy.
1, Advantages.
It is the most reliable method for confirming the cause of nipple overflow.
2.Deficiencies.
It is a reliable method to further confirm the diagnosis of early microscopic tumor foci, when the imaging and cytology diagnosis is negative and the clinical suspicion. If a puncture biopsy can be performed on the basis of imaging localization, the confirmation rate can still be improved.
IV. Near-infrared breast scan.
1. Advantages.
This method has a positive diagnostic rate of 80% to 90% for overflow caused by ductal disease in the areola area. The method is simple, non-invasive and can be repeatedly examined.
2.Deficiency:
Because of the complex anatomy of the areola area, the skin is thick and tough, which brings many inconveniences to palpation. The use of near-infrared scanning and supplemented by the injection of methylene blue contrast into the overflowing milk ducts to help the image, can improve the diagnosis rate of ductal disease in the areola area.
V. Ultrasound examination.
1.Advantages.
The diagnostic rate of this method for benign breast diseases can reach 80% to 90%, and ultrasound examination can see enlarged milk ducts, very small cysts, and sometimes intraductal papillomas or filling defects, and the diagnostic rate of malignant breast diseases can reach 71% to 90%. This method is non-invasive and painless to the patient, easy to perform, and has the advantage of high resolution.
2.Inadequacy.
It can be confused with the results of other diseases.
VI. Selective mammography.
1.Advantages.
For nipple overflow benign and malignant breast diseases have greater diagnostic value, especially for those who have nipple overflow without lumps and other features on physical examination, or other tests are negative. Selective ductography can clarify the site, nature and extent of overflow before surgery.
2. Inadequate.
The correct diagnosis rate of the etiology of nipple overflow is not ideal, and it is especially difficult to diagnose benign breast diseases.