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Vol. 32, No. 3, 2009
Issue release date: March 2009
Onkologie 2009;32:94–98

Scarless Endoscopic Papillomectomy of the Breast

Bender Ö. · Balcı F.L. · Yüney E. · Akbulut H.
First Department of General Surgery, S. B. Okmeydanı Training and Research Hospital, Istanbul, Turkey

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Background: Efforts have been made to improve minimally invasive breast surgery techniques, resulting in less tissue damage and much better cosmetic results. We evaluated the therapeutic value of a new scarless operation, endoscopic papillomectomy (EP), in patients with pathologic nipple discharge (PND). Methods: Breast ductoscopy was performed on 126 women with PND. These patients underwent a variety of appropriate ductoscopy-assisted (DA) endosurgical interventions, combined with cytologic examinations. Success was determined by recurrence of PND and by standard radiological examinations. Results: Ductoscopy was successfully performed in 102 patients. Of these 102 patients, 26 had solitary papillomas (SP), 5 had multiple papillomas (MP), 11 had intraductal debris, and 1 had a ductal epithelial surface abnormality with positive cytology. Of the 26 polypoid lesions (cytology negative), 22 were excised endoscopically (endoscopic papillomectomy). Patients with MP underwent DA-microdochectomy. Except in one patient, all discharges disappeared. After a mean ± SD follow-up time of 11.5 ± 5.8 months (range 2–22 months), there were no recurrences of nipple discharge and no radiological results suggestive of malignancy. Thus, the therapeutic efficacy of EP in our study was 95.4% (21/22). Conclusions: Ductoscopy is not only a diagnostic procedure, but is also therapeutic for breast papillomas. EP is a new scarless treatment option for patients with PND.

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