Features of diagnosis and surgical treatment of intraductal neoplasms of the breast | Ukrainian Medical Journal

The analysis and popularization of own experience in optimizing the diagnosis and surgical treatment of intraductal neoplasms of the breast with the combined use of radial and endoscopic techniques was conducted. 158 clinical observations are divided into 2 groups: in the control (n=81), traditional methods of diagnosis and surgical treatment were used, in the main (n=77) — own methods of selective galactoctodography under endoscopic control, stereotactic trepan biopsy under the Х-ray control, double endoscopically and echographically controlled marking with establishment of the areola arterial blood supply. It was shown that the combined use of known and developed techniques in accordance with the presented algorithm provides a significant (from 97.5 to 6.5%) reduction in the segment of more traumatic operations — central ductectomyes, appreciable (from 41.0 to 34.0 min) reduction in the duration of operations, statistically significant (p<0.05) (from 45.4 to 23.8 cm3) decrease in the volume of tissues removed, significant (p<0.05) (from 11.1 to 3.9%) decrease the frequency of postoperative complications and the reduction in hospitalization by 3.4 days.

Published: 23.04.2019

References:

Aksonov O.A., Bilonenko H.A., Aksonova O.H. (2017) Pat. 116603 U Ukraina, MPK (2017.01) A61B 8/00. Sposib vyboru khirurhichnoi taktyky pry vnutrishnoprotokovykh novoutvorenniakh hrudnoi zalozy. Vynakhidnyky ta patentovlasnyky Aksonov O.A., Bilonenko H.A., Aksonova O.H. (UA). № u2016 12959. Zaiavl. 19.12.2016. Opubl. 25.05.2017. Biul. № 10: 4 s.
Aksonov O.A., Smolanka I.I., Bilonenko H.A., Aksonova O.H. (2016) Pat. 106064 U Ukraina, MPK (2016.01) A61B 8/08. Sposib selektyvnoi endoskopichno kontrolovanoi renthenohalaktoduktohrafii. Vynakhidnyky ta patentovlasnyky Aksonov O.A., Smolanka I.I., Bilonenko H.A., Aksonova O.H. (UA). № u2015 11125. Zaiavl. 12.11.2015. Opubl. 11.04.2016. Biul. № 7: 2 s.
Bilonenko H.A., Siedakov I.Ie., Aksonov O.A. ta in. (2017) Pat. 119847 U Ukraina, MPK (2006.01) G01N 33/50. Sposib prytsilnoi stereotaksychnoi trepan-biopsii renthenonehatyvnykh vnutrishnoprotokovykh novoutvoren hrudnoi zalozy. Vynakhidnyky ta patentovlasnyky Bilonenko H.A., Siedakov I.Ie., Aksonov O.A., Aksonova O.H., Sukhina N.O., Khlopushyn Ye.Iu., Starushko R.V. (UA). № u201704080. Zaiavl. 24.04.2017. Opubl. 10.10.2017. Biul. № 19: 4 s.
Zhyhulin A.V., Palytsia V.Ia., Dmytrenko O.A. ta in. (2016) Onkoplastychna ta rekonstruktyvna khirurhiia raku hrudnoi zalozy. Dosvid vprovadzhennia. Klin. onkolohiia, 2(22): 19–25.
Smolanka I.I., Skliar S.Iu., Holovko T.S., Hanich O.V. (2014) Suchasni mozhlyvosti provedennia skrininhu zakhvoriuvan hrudnoi zalozy. Klin. onkolohiia, 1(13): 32–34.
Cheshuk V.Ie., Anikusko M.F. (2014) Pat. 88345 Ukraina, MPK (2014.01) A61B 17/00. Sposib vyznachennia lokalizatsii vnutrishnoprotokovoi papilomy molochnoi zalozy pid chas khirurhichnoho likuvannia. Patentovlasnyk Natsionalnyi medychnyi universytet im. O.O. Bohomoltsia (UA). № u201312183. Zaiavl. 18.10.2013. Opubl. 11.03.2014. Biul. № 5: 3 s.
Ahn S.K., Han W., Moon H.G. (2018) Management of benign papilloma without atypia diagnosed at ultrasound-guided core needle biopsy: Scoring system for predicting malignancy. Eur. J. Surg. Oncol., 44(1): 53–58.
Bahl M., Gadd M.A., Lehman C.D. (2017) Diagnostic utility of MRI after negative or inconclusive mammography for the evaluation of pathologic nipple discharge. AJR. Am. J. Roentgenol., 209(6): 1404–1410.
Chevrot А., Pelissier A., Rouzier R. (2017) Papillome mammaire: comment je fais… une pyramidectomie guidée par un fil de crin. Gynecol. Obstet. Fertil. Senol., 45(11): 632–633.
Cil T.D., McCready D. (2018) Modern approaches to the surgical management of malignant breast disease. The role of breast conservation, complete mastectomy, skin- and nipple-sparing mastectomy. Clin. Plast. Surg., 45(1): 1–11.
Cohen Y. (2016) Conventional ductography combined with digital breast tomosynthesis for imaging of pathologic nipple discharge. AJR Am. J. Roentgenol., 206 (2): W44.
Castellano I., Metovic J., Balmativola D. et al. (2017) The impact of malignant nipple discharge cytology (NDc) in surgical management of breast cancer patients. PLoS One, 12(8): e0182073.
Colombo P.E., Vincent-Salomon A., Chateau M.C. et al. (2014) Breast surgeon role in the management of high-risk breast lesions. Bull. Cancer, 101(7/8): 718–729.
Dupont S.C., Boughey J.C., Jimenez R.E. et al. (2015) Frequency of diagnosis of cancer or high-risk lesion at operation for pathologic nipple discharge. Surgery, 158(4): 988–995.
Han Y., Li J., Han S. et al. (2017) Diagnostic value of endoscopic appearance during ductoscopy in patients with pathological nipple discharge. BMC Cancer, 17(1): 300.
Hartmann L.C., Degnim A.C., Santen R.J. et al. (2015) Atypical hyperplasia of the breast — risk assessment and management options. N. Engl. J. Med., 372(1): 78–89.
Lee S.J., Trikha S., Moy L. et al. (2017) ACR Appropriateness criteria^® evaluation of nipple discharge. J. Am. Coll. Radiol., 14(5S): s138–s153.
Lippa N., Hurtevent-Labrot G., Ferron S., Boisserie-Lacroix M. (2015) Nipple discharge: the role of imaging. Diagn. Interv. Imaging, 96(10): 1017–1032.
National Cancer Institute of Ukraine (2017) Bulletin of national cancer registry of Ukraine (http://www.ncru.inf.ua/publications/BULL_18/index_e.htm).
Xu Z., Xing W., Li Q. et al. (2015) Assessment of diagnostic and therapeutic value of ductoscopy biopsy in single intraductal papillary lesion compared with open surgery. Cancer Res., 75 (9 suppl.): Abstr. 2–13–10.
Yilmaz R., Bender O., Yabul F.Q. et al. (2017) Diagnosis of nipple discharge: value of magnetic resonance imaging and ultrasonography in comparison with ductoscopy. Balkan Med. J., 34(2): 119–126.
Yuan Z., Qu X., Zhang Z.T., Jiang W.G. (2017) Application of localization and needle placement guided by mammographic, ultrasound and fiberoptic ductoscopy for resection of non-palpable breast lesions. Anticancer Res., 37(8): 4523–4527.