Abstract
BackgroundPathologic nipple discharge (PND) is a common complaint often associated with breast cancer. However, when ultrasound and mammography are negative, the chances of malignancy are lower than 5%. Currently, major duct excision and microdochectomy are often recommended to alleviate symptoms and definitely rule out malignancy, but can cause infections and breastfeeding problems. Ductoscopy is a minimally invasive endoscopy technique that allows visualization of the mammary ducts and may not only obviate surgery but also detect malignancy. The aim of this study was to determine quality of life (QOL) after ductoscopy in patients with PND.Materials and methodsAll PND patients referred for ductoscopy between 2014 and 2015 to our hospital were included. Ductoscopy procedures were performed under local anaesthesia in the outpatient clinic. Patients were asked to fill out questionnaires (Breast-Q, EQ-5D-5L and SF-36) on the day of ductoscopy, and after 2 weeks, 3 and 6 months. Additionally, we performed reliability analysis to determine if these questionnaires were suitable for PND patients.ResultsFifty consecutive patients underwent ductoscopy of whom 47 patients participated in this study. One domain of SF-36 (vitality) varied significantly over time. Breast-Q, SF-36 and EQ-5D-5L showed that QOL after ductoscopy for PND was unaffected by ductoscopy. Success of the ductoscopy procedure was a significant predictor for satisfaction with the result domain.ConclusionDuctoscopy is a minimally invasive technique that does not seem to impact QoL of PND patients over time. Breast-Q, SF-36 and EQ-5D-5L seem to be suitable existing QOL tests for PND patients undergoing ductoscopy, whereas SF-36 would require modifications.
Highlights
Pathologic nipple discharge (PND) is the third most common breast-related complaint, after pain and palpable lumps [1]
We evaluated quality of life (QOL) of patients with PND that underwent ductoscopy
No statistically significant changes were observed in the overall scores of the Breast-Q, SF-36 and EQ-5D-5L questionnaires at baseline compared to 2 weeks, 3 and 6 months after ductoscopy, indicating that ductoscopy does not negatively influence QOL
Summary
Pathologic nipple discharge (PND) is the third most common breast-related complaint, after pain and palpable lumps [1]. Ductoscopy is a minimally invasive micro-endoscopic technique that may obviate the need for invasive surgery in patients with PND. It enables real-time visualization of the milk ducts of the breast. Previous studies showed the success of ductoscopy in finding the intraductal lesion causing PND before or during duct excision [19,20,21,22,23]. The aim of this study was to determine quality of life (QOL) after ductoscopy in patients with PND. Conclusion Ductoscopy is a minimally invasive technique that does not seem to impact QoL of PND patients over time. Breast-Q, SF-36 and EQ-5D-5L seem to be suitable existing QOL tests for PND patients undergoing ductoscopy, whereas SF-36 would require modifications
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