Ductoscopy is a medical procedure that uses a tiny, flexible scope to directly visualize the interior of the breast’s milk ducts. This technique aims to identify abnormalities causing symptoms.
What is Ductoscopy?
A ductoscope, a very small, flexible fiberoptic instrument (0.35 mm to 0.9 mm in diameter), is gently inserted into a milk duct through the nipple opening. Its tip features a camera that projects real-time, magnified images (up to 60 times) onto a monitor, allowing physicians to visually inspect the duct’s inner walls. Saline solution may be injected to expand the duct, improving visualization and clearing discharge or debris.
Why is Ductoscopy Performed?
Ductoscopy is primarily performed to investigate pathological nipple discharge, especially when it is spontaneous, persistent, from a single duct, or appears bloody or clear. While most nipple discharge is benign, ductoscopy helps determine its source, differentiating between non-cancerous conditions like intraductal papillomas and more serious concerns such as ductal carcinoma in situ or invasive breast cancer. It can detect lesions as small as one millimeter, which may not be visible on conventional imaging tests like mammography or ultrasound. The procedure provides information that guides further diagnostic and treatment decisions, potentially reducing the need for more invasive surgeries.
Preparing for and Undergoing Ductoscopy
Preparation for ductoscopy involves instructions from your healthcare provider. You may need to avoid certain medications, like blood thinners, and fasting might be necessary if light sedation is planned. A warm towel may be applied to the breast for 10-15 minutes to relax the periareolar sphincter muscle.
During the procedure, local anesthesia is applied to the nipple area to minimize discomfort; light sedation may also be used. The physician applies gentle pressure or suction to identify the discharging duct opening. Once identified, a tiny catheter is inserted into the duct, followed by the ductoscope. If abnormal areas are observed, instruments can collect tissue samples (biopsies) for laboratory analysis. The procedure takes about 45 minutes, varying if biopsies are taken.
Interpreting Results and Recovery
Following a ductoscopy, preliminary findings may be discussed immediately, but definitive results, especially from biopsies, require a pathology report. This report becomes available within several days to a week. After the procedure, mild discomfort, slight bruising, or a small amount of clear or bloody discharge from the nipple for a day or two is common.
Most individuals can resume normal activities quickly. Contact your healthcare provider if you experience excessive bleeding, increasing pain, significant swelling, or signs of infection, such as redness, warmth, or pus-like discharge from the nipple. The ductoscopy results will guide subsequent steps, which may include further monitoring, additional diagnostic tests, or treatment if an abnormality is confirmed.