Breast Surgeons at Beth Israel's Cancer Center Perform Ductoscopy in the Doctor's Office Rather than in the Operating Room

Ductoscopy can identify early changes in the breast similar to colonoscopy for the colon.

First Webcast: Wednesday, October 15th, 2003

NEW YORK - Over 200,000 women will be diagnosed with breast cancer in the United States this year. Early detection remains the key to a favorable outcome. Research has shown that most breast cancer originates in the milk ducts of the breast. Ductal lavage is an outpatient procedure which allows a sampling of cells from the milk ducts. Now, breast surgeons at Beth Israel Medical Center are taking ductal lavage one step further with a new technique called mammary ductoscopy with intraductal biopsy. This procedure involves the placement of a tiny catheter into the milk duct, through which the surgeon inserts a tiny (0.7 mm) fiberoptic endoscope (with a camera at the end of it), enabling the physician to visualize on a video monitor the breast ducts 60 times their actual size.

Susan K. Boolbol, M.D., breast surgeon at Beth Israel Cancer Center explains, “With ductal lavage, a tiny catheter is placed into the nipple and fluid is aspirated from the milk duct, then sent to the laboratory and analyzed. With ductoscopy, a fiberoptic endoscope is inserted into the milk duct, enabling the physician to actually visualize the inside of the milk ducts and biopsy any abnormalities seen at that time. This information may affect further follow-up and treatment.”

Sheldon Feldman, M.D., Chief of the Louis Venet, MD Comprehensive Breast Service at Beth Israel says, “Ductoscopy allows us to obtain real-time information about changes in the milk ducts. This incredibly exciting new technology allows us to access the source of most breast cancer. Intraductal evaluation has the potential to revolutionize the diagnosis and treatment of breast disease.

If any abnormality is visualized or atypical cells are found, an intraductal biopsy of lesions found inside the milk ducts can be performed from within the duct itself, possibly eliminating the need for surgical intervention. The best way to describe this procedure to patients is that ductoscopy can identify early changes within a portion of the breast similar to colonoscopy for the colon. With ductoscopy, sedation is not required. A local anesthetic cream is applied to the nipple as needed. This allows for the patient to see the images displayed on the computer screen, along with the physician. The entire procedure for ductoscopy with intraductal biopsy takes approximately 45 minutes and is well tolerated.”

For more information about ductal lavage and ductoscopy, please call 212/844-8959. If you would like to interview Dr. Sheldon Feldman /Dr. Susan K. Boolbol and a patient, please call Michelle Pipia-Stiles in the public affairs office at 212/523-7772, so that the necessary arrangements can be made.