Microdochectomy

A microdochectomy is a surgical procedure used to remove a breast duct, typically performed to diagnose and treat conditions affecting the milk ducts, such as nipple discharge or ductal carcinoma in situ (DCIS).

Indications for Microdochectomy

• Nipple discharge, particularly if it is bloody, serous, or persistent
• Suspicious or abnormal cells found in the nipple discharge
• Ductal carcinoma in situ (DCIS) or other breast cancers that are confined to the milk ducts
• Papillomas or other benign tumors within the breast ducts
• Other conditions affecting the breast ducts, such as duct ectasia or periductal mastitis

Procedure

The microdochectomy procedure typically involves the following steps:

1. The patient is given general anesthesia or local anesthesia with sedation to ensure comfort during the procedure.
2. A small incision is made in the skin, usually around the areola (the pigmented area surrounding the nipple).
3. The surgeon identifies the affected duct and carefully dissects it from the surrounding tissue.
4. The entire duct is then removed, and the incision is closed with sutures or staples.

Types of Microdochectomy

There are two main types of microdochectomy:

• Major duct excision: This involves removing a larger section of the breast duct, often performed for conditions like DCIS or papillomas.
• Minor duct excision: This is a more limited procedure, where only a small portion of the duct is removed, typically for diagnostic purposes or to treat minor conditions.

Risks and Complications

As with any surgical procedure, microdochectomy carries some risks and potential complications, including:

• Bleeding or hematoma
• Infection
• Scarring or changes in nipple sensation
• Temporary or permanent changes in breast appearance
• Recurrence of the underlying condition

Recovery and Follow-up

After a microdochectomy, patients can expect:

• A short hospital stay or outpatient procedure
• Pain management with medication
• Follow-up appointments to remove sutures or staples and monitor healing
• Further testing or treatment, depending on the results of the procedure and pathology report

Pathology Report

The removed duct is sent to a laboratory for pathological examination to:

• Confirm the diagnosis
• Check for any cancer cells or precancerous changes
• Determine if additional treatment is necessary