Results of the radioguided surgeries among the patients with pathological nipple discharge

Introduction: Nipple discharge is the third most common complaint of the breast diseases following the breast mass and the breast pain. The majority of the lesions causing pathological nipple discharge (PND) consist of non-palpable breast lesions (NPBLs). When non-operative diagnostic tools are inadequate to distinguish the diagnosis, the pathological duct should be removed to obtain definitive diagnosis. In this study, we aimed to present the results of radioguided surgery for NPBLs in patients with PND. Methods: Patients with PND who underwent radioguided occult lesion localization (ROLL) and excision in our tertiary care referral center were included in this study. Patients were evaluated in detail for age, gender, clinical data, radiological data, marking procedure, surgical results, pathological results, complication rates, local recurrence rates and follow-up period. Results: A total of 66 patients (98.5%) were able to successfully localize the lesion with ROLL. Lesions were marked with ultrasonography (USG) in 81.8% patients (n=54), while the rate of marking with mammography (MMG) was 18.2% (n=12). The mean time duration of preoperative marking was 14±4.3 minutes. The mean operation time was determined as 35 ± 12 minutes. Malignancy was detected in 19.7% of the patients (n=13).  Surgical margin negativity was achieved in 92.3% (n=12) of patients with malignancy. No local recurrence was detected during the follow-up period (median 62(12-116) months). Conclusion: In our study, it has been shown that radioguided occult lesion localization and excision can be easily performed technically for non-palpable breast lesions in patients with pathological nipple discharge and provides sufficient safe surgical margins with acceptable cosmetic results.