Ductoscopy | |
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Purpose | collecting epithelial cells from milk ducts |
Ductoscopy or mammary ductoscopy (also: breast duct endoscopy, galactoscopy) is a medical diagnostic procedure for viewing and collecting epithelial cells and other internal features of the milk ducts. It is capable of detecting smaller abnormalities than mammograms, MRI or ultrasound tests.
Ductoscopy can be performed in a physician's office or as an outpatient in a clinic. A fiber optic scope less than a millimeter thick is inserted into the milk duct at the nipple and threaded deep into the breast through the duct. No incision is involved. An imaging system displays the output of the scope on a computer monitor. Samples of epithelial cells can be collected onto microscope slides for further analysis. Local anesthetic may be employed to reduce discomfort.
Latest Mammary Ductoscope, also called Micro Endoscope, is available with the diameter of 0.35 mm. The endoscopes is used along with a 3-way cannula. The other two ports are used for saline irrigation and Biopsy Forceps of 0.4 mm diameter.
Ductoscopy can also be performed in conjunction with a lumpectomy, allowing the surgeon to achieve clean margins with a minimum of excess tissue removed.
The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues.
Morphogenesis is the biological process that causes a cell, tissue or organism to develop its shape. It is one of three fundamental aspects of developmental biology along with the control of tissue growth and patterning of cellular differentiation.
Exocrine glands are glands that secrete substances on to an epithelial surface by way of a duct. Examples of exocrine glands include sweat, salivary, mammary, ceruminous, lacrimal, sebaceous, prostate and mucous. Exocrine glands are one of two types of glands in the human body, the other being endocrine glands, which secrete their products directly into the bloodstream. The liver and pancreas are both exocrine and endocrine glands; they are exocrine glands because they secrete products—bile and pancreatic juice—into the gastrointestinal tract through a series of ducts, and endocrine because they secrete other substances directly into the bloodstream. Exocrine sweat glands are part of the integumentary system; they have eccrine and apocrine types.
The nipple is a raised region of tissue on the surface of the breast from which, in females, milk leaves the breast through the lactiferous ducts to breastfeed an infant. The milk can flow through the nipple passively or it can be ejected by smooth muscle contractions that occur along with the ductal system. Male mammals also have nipples but without the same level of function, and often surrounded by body hair.
A mammary gland is an exocrine gland in humans and other mammals that produces milk to feed young offspring. Mammals get their name from the Latin word mamma, "breast". The mammary glands are arranged in organs such as the breasts in primates, the udder in ruminants, and the dugs of other animals. Lactorrhea, the occasional production of milk by the glands, can occur in any mammal, but in most mammals, lactation, the production of enough milk for nursing, occurs only in phenotypic females who have gestated in recent months or years. It is directed by hormonal guidance from sex steroids. In a few mammalian species, male lactation can occur. With humans, male lactation can occur only under specific circumstances.
Apocrine is a term used to classify the mode of secretion of exocrine glands. In apocrine secretion, secretory cells accumulate material at their apical ends, often forming blebs or "snouts", and this material then buds off from the cells, forming extracellular vesicles. The secretory cells therefore lose part of their cytoplasm in the process of secretion.
Mouse mammary tumor virus (MMTV) is a milk-transmitted retrovirus like the HTL viruses, HI viruses, and BLV. It belongs to the genus Betaretrovirus. MMTV was formerly known as Bittner virus, and previously the "milk factor", referring to the extra-chromosomal vertical transmission of murine breast cancer by adoptive nursing, demonstrated in 1936, by John Joseph Bittner while working at the Jackson Laboratory in Bar Harbor, Maine. Bittner established the theory that a cancerous agent, or "milk factor", could be transmitted by cancerous mothers to young mice from a virus in their mother's milk. The majority of mammary tumors in mice are caused by mouse mammary tumor virus.
Nipple discharge is fluid from the nipple, with or without squeezing the breast. The discharge can be milky, clear, green, purulent, bloody, or faintly yellow. The consistency can be thick, thin, sticky, or watery.
Fibroadenomas are benign breast tumours characterized by an admixture of stromal and epithelial tissue. Breasts are made of lobules and ducts. These are surrounded by glandular, fibrous and fatty tissues. Fibroadenomas develop from the lobules. The glandular tissue and ducts grow over the lobule to form a solid lump.
Lactiferous ducts are ducts that converge and form a branched system connecting the nipple to the lobules of the mammary gland. When lactogenesis occurs, under the influence of hormones, the milk is moved to the nipple by the action of smooth muscle contractions along the ductal system to the tip of the nipple. They are also referred to as galactophores, galactophorous ducts, mammary ducts, mamillary ducts or milk ducts.
A galactocele is a retention cyst containing milk or a milky substance that is usually located in the mammary glands. They can occur in women during or shortly after lactation.
Ductal carcinoma in situ (DCIS), also known as intraductal carcinoma, is a pre-cancerous or non-invasive cancerous lesion of the breast. DCIS is classified as Stage 0. It rarely produces symptoms or a breast lump one can feel, typically being detected through screening mammography. It has been diagnosed in a significant percentage of men.
Myoepithelial cells are cells usually found in glandular epithelium as a thin layer above the basement membrane but generally beneath the luminal cells. These may be positive for alpha smooth muscle actin and can contract and expel the secretions of exocrine glands. They are found in the sweat glands, mammary glands, lacrimal glands, and salivary glands. Myoepithelial cells in these cases constitute the basal cell layer of an epithelium that harbors the epithelial progenitor. In the case of wound healing, myoepithelial cells reactively proliferate. Presence of myoepithelial cells in a hyperplastic tissue proves the benignity of the gland and, when absent, indicates cancer. Only rare cancers like adenoid cystic carcinomas contains myoepithelial cells as one of the malignant components.
Duct ectasia of the breast, mammary duct ectasia or plasma cell mastitis is a condition that occurs when a milk duct beneath the nipple widens, the duct walls thicken, and the duct fills with fluid. This is the most common cause of greenish discharge. Mammary duct ectasia can mimic breast cancer. It is a disorder of peri- or post-menopausal age.
Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process naturally occurs with all sexually mature female mammals, although it may predate mammals. The process of feeding milk in all female creatures is called nursing, and in humans it is also called breastfeeding. Newborn infants often produce some milk from their own breast tissue, known colloquially as witch's milk.
Breast development, also known as mammogenesis, is a complex biological process in primates that takes place throughout a female's life.
Microdochectomy is the surgical removal (excision) of a lactiferous duct. A mere incision of a mammary duct is called microdochotomy.
A nipple bleb is a blister on the nipple that can be filled with serous or other fluid. It may be pink or light yellow. It is thin-walled and may appear as a small blister, more than 5 mm in diameter. It can also be referred to as a bulla. Some clinicians may also include milk blisters as a type of bleb. In addition, a blocked Montgomery gland may also be called a nipple bleb though its cause is different than a milk or serous-filled bleb on the nipple. In some cases the bleb may be associated with an adjacent blocked sebaceous cyst.
Papillary carcinomas of the breast (PCB), also termed malignant papillary carcinomas of the breast, are rare forms of the breast cancers. The World Health Organization (2019) classified papillary neoplasms of the breast into 5 types: intraductal papilloma, papillary ductal carcinoma in situ (PDCIS), encapsulated papillary carcinoma (EPC), solid-papillary carcinoma (SPC), and invasive papillary carcinoma (IPC). The latter four carcinomas are considered here; intraductal papilloma is a benign neoplasm. The World Health Organization regarded solid papillary carcinoma as having two subtypes: in situ and invasive SPC.