Innovative use of optical coherence tomography catheter via nipple orifice: A case report of first intraductal images of florid ductal hyperplasia

Abstract

The incidence of malignancy in patients with pathologic nipple discharge (PND) varies from 1% to 23% (1). Currently, methylene blue dye or lacrimal probe guided isolated duct excision is still the standard treatment of PND. Majority of those patients are not with cancerinvolved ducts and have unnecessary surgery to reveal the definitive histopathology. With conventional imaging, it is not possible to understand whether those ducts involve cancer or not (2). It is well established that ductoscopy is a novel technique that could diagnose a single papilloma; however, it is insufficient to diagnose an in situ or invasive cancer (3,4). Currently, optical coherence tomography (OCT) is used as a non-invasive imaging test that utilizes light waves to capture cross-sectional pictures of retina or coronary arteries (5). In our novel approach, a miniaturized OCT catheter is inserted into the breast ductal system via the nipple orifices to provide detailed real-time imaging of breast ductal epithelial anatomy.