Sonographically guided mammotome excision of ducts in the diagnosis and management of single duct nipple discharge

Abstract 

Aim

To describe our experience in the use of ultrasound guided mammotome in the diagnosis and management of single duct nipple discharge.

Methods

Patients for whom surgical excision of the single duct had been advised for single duct nipple discharge were offered ultrasound guided mammotome excision of the duct as an alternative to surgical excision. The procedure was performed in the breast clinic by a surgeon or a breast clinician who had interventional ultrasound skills.

Results

Seventy-seven patients had 81 procedures. Follow-up at a mean time of 16 months revealed resolution of the presenting problematic discharge in 95% of patients. Nipple discharge recurred in four patients. Two patients had microdochectomy and two had a repeat mammotome for recurrence of symptoms. Complications were mild and infrequent.

Conclusion

Ultrasound guided mammotome excision is a new tool in the work up and management of single duct nipple discharge. It can be performed under local anaesthetic by a surgeon/breast clinician or radiologist with interventional ultrasound skills. It has the potential to replace surgical excision (microdochectomy) as a treatment for nipple discharge.

Keywords: Single duct nipple discharge, Ultrasound guided mammotome, Bloodstained discharge, Microdochectomy, Breast, Benign duct papilloma, Malignancy