Diagnostic value of ductoscopy in the diagnosis of nipple discharge and intraductal proliferations in comparison to standard methods

Onkologie. 2007 May;30(5):243-8. doi: 10.1159/000100848. Epub 2007 Apr 24.


Background: Ductoscopy is gaining increased importance in the diagnosis of nipple discharge of unclear origin and intraductal proliferation. For this reason we compared its diagnostic value and feasibility to standard diagnostic methods.

Material and methods: Ductoscopy was compared to mammography, galactography, sonography, magnetic resonance imaging (MRI), nipple smear, fine needle aspiration cytology (FNAC), and high-speed core biopsy; feasibility, sensitivity, and specificity were investigated for each method.

Results: 71 ductoscopies were evaluated, which were followed up by open biopsies. Here, 3 invasive and 8 ductal carcinomas in situ were found, as well as 3 atypical ductal hyperplasias, 44 papillomas/papillomatoses, and 13 benign findings. Feasibility of ductoscopy was in this series 100%. Duct sonography showed the highest sensitivity (67.3%), followed by MRI (65.2%), galactography (56.3%), ductoscopy (55.2%), and FNAC (51.9%). The highest specificity was shown by FNAC, core biopsy, and galactography (each 100.0%), followed by mammography (92.3%), nipple smear (77.8%), ductoscopy, and duct sonography (each 61.5%); the lowest specificity was displayed by MRI (25.0%).

Conclusion: The results confirm that ductoscopy can be performed within the same range of sensitivity and specificity as other techniques. In order to make conclusive statements about ductoscopy, especially in order to precisely define the indications for this method, a prospective multicenter study was initiated.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Breast Diseases / diagnosis
  • Breast Diseases / pathology
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / pathology
  • Carcinoma, Ductal, Breast / diagnosis*
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Intraductal, Noninfiltrating
  • Cell Division / physiology*
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Endoscopy*
  • Female
  • Galactorrhea / etiology*
  • Galactorrhea / pathology
  • Humans
  • Mammary Glands, Human* / pathology
  • Middle Aged
  • Nipples* / pathology
  • Papilloma, Intraductal / diagnosis*
  • Papilloma, Intraductal / pathology
  • Precancerous Conditions / diagnosis*
  • Precancerous Conditions / pathology
  • Retrospective Studies
  • Sensitivity and Specificity