HEALTH OF WOMAN. 2016.9(115):28–32; doi 10.15574/HW.2016.115.28 
 

Optimization of diagnostic and treatment tactics at patients with pathological nipple discharge 
 

Smolanka I. I., Aksyonov A. A., Aksyonova E. G., Belonenko G. A.

National cancer Institute, MH Ukraine, Kyiv

Ukrainian scientific and practical center for endocrine surgery, transplantation of endocrine organs and tissues of the MOH of Ukraine, Kyiv

The objective: the analysis of own scientific data and working out of optimal diagnostic and treatment algorithm at pathological nipple discharge (PND).

Patients and methods. 202 patients with PND after clinical, cytologic, radial and endoscopic examinations were operated using 196 traditional ductectomies and 12 interventions after preoperative markings of intraductal neoplasms (IDN) on own original metod (6 women were operated on both sides). After histological verification sensitivity, specificity and accuracy of the used diagnostic tests were сalculated.

Results. Diagnostic specificity of X-ray galactoductography (GDG) and endoscopic mammoductoscopy (EMDS) were 22.6% and 47.4% correspondingly. The leading reason of pseudo-positive results of EМDS consisted in peripherical location IDN – out of 24 IDN located farther than 3 cm from a nipple, only 17 (70.8%) were confirmed histologically.

False results after EMDS at double preoperative marks of IDN on own original metod were not registered. The optimization sequence of the diagnostic actions providing the differentiated choice of surgical tactics at women of reproductive or menopausal age is offered.

Conclusions. Rising of diagnostic effectivenely of EMDS as a modern, high-tech methods at PND, is possible by using of double synchronous preoperative marks of peripherical located IDN. At PND use of the known and offered techniques according to the algorithm developed by us provides the differentiated choice of individual surgical tactics depending on a reproductive condition and age of patients.

Key words: breast, pathological nipple discharge, algorithm diagnostic and treatment.

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