Abstract P4-03-08: Pathological analysis of intraductal papillary lesions in 3690 patients

Abstract

Abstract Background:Papillary lesions of the breast (PL) account for 1 - 2% in breast tumors and 10% in benign tumors. Ductoscopy due to its high rate (60 times) amplification and visualization of lesions, which makes it possible to directly visualize the duct from the orifice of the duct well into the periphery. It could not only find abnormities which other tests could not provide, but also predict histological diagnosis.However, ductoscopy findings and pathological results are not always consistent. Ductoscopy examine is limited by many factors such as complicated anatomical structure of breast and ductal obstruction, so in some cases it may have missed diagnosis. Lesions could be missed due to extrusion and shedding during ductoscopy examine procedure and preparation of pathological section. Methods:In this study, we retrospectively studied on 4170 papillary lesions diagnosed by ductoscopy in 3690 patients from April 23, 2008 to October 31st, 2012 and compared incidence of each disease. These cases were evaluated by final histopathology(42.2% solitary papillary lesion, 32.5% multiple papillomatosis, 13.0% premalignant or malignant lesions, 6.5% mammary duct or plasma cell mastitis, 5.7% epithelial hyperplasia). The sensitivity of ductoscopy for PL in this study was 87.8%, and specificity was 89.2%. Results and Discussion:Spontaneous nipple discharge(SND) is the third third most common presenting symptom of breast disease accounting for 3∼8% of breast symptoms. But in our experience, not all of the intraductal lesions would have SND, especially in those cases which localized more distally. Besides, intraductal lesions in premalignant or malignant lesions cases would have more incidence to localize distally than their benign papilloma. Thus, if we only take ductoscopy on patients who suffer SND, we might have some missed diagnosis for those people who did not suffer SND including malignant lesions.At present, although ductoscopy is not routine examination for breast cancer screening, we consider that for people who share a high-risk of developping breast cancer, although she might not have SND, ductoscopy could be a selective screen tool. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-03-08.