A randomized controlled study of selective microdochectomy guided by ductoscopic wire marking or methylene blue injection

Am J Surg. 2011 Feb;201(2):221-5. doi: 10.1016/j.amjsurg.2010.03.011. Epub 2010 Sep 26.

Abstract

Background: Methylene blue identification of lesions during microdochectomy is often inaccurate, resulting in large dissection and tissue damage. A wire placed via ductoscopy preoperatively into the pathologic duct may aid identification and reduce the amount of dissection required.

Methods: A total of 53 patients being evaluated for nipple discharge were randomized to receive ductoscopy with either methylene blue or wire marking of the lesion before microdochectomy. Patient clinical characteristics and surgical outcomes were evaluated.

Results: There were 28 patients who received methylene blue marking and 25 who received wire marking of the lesions. There were no differences between the demographic or clinical characteristics of the groups. Wire marking was associated with less surgical time, smaller incisions, and smaller surgical specimens, but the same diagnostic accuracy.

Conclusions: Wire marking of lesions for microdochectomy is associated with less dissection and tissue damage than methylene blue, yet the same diagnostic accuracy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Breast Diseases / diagnosis
  • Breast Diseases / surgery
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Coloring Agents
  • Endoscopy / methods*
  • Exudates and Transudates*
  • Female
  • Humans
  • Mammary Glands, Human / pathology
  • Mammary Glands, Human / surgery
  • Mammography
  • Methylene Blue*
  • Middle Aged
  • Nipples / pathology
  • Nipples / surgery
  • Ultrasonography, Mammary

Substances

  • Coloring Agents
  • Methylene Blue