Breast ductoscopy is the abbreviation for ultra-fine fiber optic duct catheter endoscopy. It is non-invasive, has little patient pain, and is easy to insert into the mammary gland. The easy operation of the breast tube is small, and the trauma is small, and it can effectively improve the diagnosis rate of the bulging lesions in the milk duct. It can also be used for the treatment of benign breast duct lesions, such as breast duct-assisted lesions, minimally invasive resection of the duct, and plasmacysity. Treatment of mastitis, localization of tumor guidewire in the duct, etc.Basic Information
Specialist classification: Oncology examination classification: other examinations
Applicable gender: whether women are fasting: not fastingTips: Before the check: taboo: pay attention to the special history of breast disease, various diseases may have an impact on the examination. Normal value
Check that the nipple discharge is normal.Clinical significance
1. All kinds of nipple discharge, especially in patients with nipple bloody discharge and yellow discharge, the incidence of neoplastic lesions in the milk duct is about 1/3 to 1/2, and there are many cases of white discharge patients. For the breast tube mass, it is necessary to perform surgical treatment after breast ductoscopy;
2. The areola area with nipple discharge. Most of the tumors in this area are intraductal tumors or fibroadenomas, which are closely related to the milk duct. The breast duct can be confirmed by breast ductoscopy to guide the surgical resection. Tumors and lesions of the milk duct, reducing the chance of local recurrence after surgery;
3. In patients with plasma cell mastitis around the areola, plasma cell mastitis is caused by the proximal end of the milk duct, the secretions of the milk duct, exfoliated cells, and inflammatory cells, which cause acute and chronic inflammation of the breast. The laparoscopic can wash and collect the exfoliated cells in the milk duct, and perform cytological examination to confirm the diagnosis. At the same time, it can also rinse and clear the diseased milk duct to achieve the purpose of drainage. In addition, if the inflammation is limited, it can also be used in the mastoscopy. Defining the diseased milk duct, surgically removing the diseased milk duct and local scar tissue;
4. Breast pain is a type of breast hyperplasia, partly due to blockage of the proximal milk duct, resulting in poor drainage of the distal milk duct, deformation, breast duct lavage, dredge of the milk duct, Help to confirm the diagnosis and achieve a certain therapeutic effect;
5. For patients with lactation cysts, the symptoms can be improved after clearing the milk duct.
People who need to be examined: the breasts touch the crowd with a lump and nipple discharge.Precautions
Forbidden before examination: Pay attention to the particularity of the history of breast disease, and various diseases may have an impact on the examination.
Requirements for inspection: Checking for relaxation, checking may cause physical and psychological burdens, should be actively faced, and actively cooperate with the inspection. The examination needs to expose the breasts, so the upper body should wear clothes that are easy to take off. For patients with newly diagnosed breast diseases, if they are not satisfied with the physical examination, they can cooperate with the patients and check again at the best physical examination time, such as on the 10th day of the menstrual cycle to avoid physiological changes in the breast during the menstrual cycle. The interference caused. The examination should be adequately illuminated to avoid neglecting signs caused by minor lesions. The patient has a slight pain and does not need to be nervous.Inspection process
The blood pressure was routinely measured before the examination, and the electrocardiogram was performed. Introduce the examination process and precautions to the patient so that they are fully psychologically prepared to better cooperate with the examination. The patient was placed in a supine position, centered on the affected nipple, routinely disinfected with 0.2% iodophor, and one sterilized escutcheon was placed. Lift the nipple and press the area around the areola properly to confirm the position of the spilled milk hole. If it is not confirmed, the breast can be pressed against the chest wall. The secretion port is mostly single hole, even porous; sometimes the residual secretion of the nipple affects the observation, and can be removed with a dry cotton ball. After confirming the opening, insert the 1/4-pin and the nipple vertically and carefully. The sign of successful insertion should be no obvious resistance, the patient is painless, and a small amount of liquid with the same color as the discharge can be drawn into the needle. When injecting 1% lidocaine 0.1-0.3 mL infiltration anesthesia, there is no resistance, and the patient has only slight Pain, then use the Bowman lacrimal sac probe to gradually expand the overflow milk duct opening from fine to coarse, and properly leave the probe to fully expand the overflow milk duct. For patients with turbid or bloody discharge, the saline can be injected through the flat needle, and the breast is drained gently until the clear liquid is discharged, so that the lens can be observed. The FDS was inserted along the dilated milk duct, and the syringe was tightly connected to the FDS water injection port. The gas retained in the FDS was driven away by physiological saline, and physiological saline or 1% lidocaine physiological saline was continuously injected to expand the milk duct and maintain the intracavity pressure. After filling and satisfied, you can see the milk duct cavity. While observing, slowly enter the mirror into the mirror, to the branch of the milk duct, adjust the angle of the endoscope and the branch opening, select the abnormal opening, and find the branch of the III~IV branch. (If there is no tumor blocking). After setting the mirror, adjust the focal length to make the image of the screen clear, and observe whether the wall of the tube is rough, whether there is bulge, whether there is secretion or stenosis in the lumen. Observe the traits, size, shape, color, quantity, activity and location of the uplift lesions, locate, photograph, record, archive, check the end, drain the physiological saline in the milk duct, wash it properly, apply erythromycin ointment to the nipple, cover the sterilized Gauze, forbidden on the day after surgery.Not suitable for the crowd
Inappropriate people: lactating women.Adverse reactions and risks
No related complications and hazards.