Study of Endoscopy-guided LASER Therapy for Intraductal Minimal Lesions of the Breast

导管内乳头状瘤(乳头状瘤)是乳头溢液的主要原因，没有明显的肿块。本文对非手术治疗乳头状瘤的方法及临床应用的可能性进行了研究。乳头状瘤多发生在乳头附近的乳管内，扩散范围小于2.0 cm。此外，许多乳头状瘤在导管造影上表现为充盈缺陷，在内窥镜检查中表现为半球结节。激光治疗的适应证为：1)乳头附近导管造影显示孤立充盈缺损区或充盈缺损区中断；2)纤维乳管镜下见半球结节；3)刮管细胞学检查结果为良性。经激光治疗知情同意后，进行激光治疗。激光治疗的设备为：内窥镜直径为0.65 mm或0.75 mm，通过内窥镜的气道引入激光纤维(外径为0.20 mm)。本研究使用的是Nd-YAG激光。6例中4例乳头状瘤完全消失。2例出现狭窄改变，均行显微外科手术。105-928的实际能量。J.是治疗乳头状瘤所必需的。虽然存在治疗时间长、导管表面狭窄等问题，但对于非手术治疗无法治愈的乳头状瘤，该疗法仍是一种有价值的治疗方法。

Intraductal papilloma (papilloma) is an main cause of nipple discharge with no palpable mass. The method of endoscopy-guided LASER therapy which was one of non-surgical treatments for papilloma, was studied as well as the possibility of its clinical use. Most of papilloma grew in the lactiferous duct near the nipple and the spreading size was less than 2.0cm. Furthermore, many papilloma showed a filling defect on ductogram and a hemisphere nodule on endoscopic examination. Indication of LASER therapy was as follows ; 1) Solitary filling defect or interruption by filling defect on ductogram near the nipple, 2) Hemisphere nodule on fiberoptic ductoscopy, 3) Results of tube curette cytology is benign. After the informed consent of the LASER therapy, it was performed. The equipment of the LASER therapy was as follows : The diameter of endoscope was 0.65mm or 0.75mm and LASER fiber (outer diameter was 0.20mm) was introduced through the air channnel of the endoscope. Nd-YAG-LASER was used in this study. Papilloma was completely disappeared in four of the six cases. Stenotic changes occurred in two cases and microdochectomy was performed in those patients. The actual energy of 105-928. J.was necessary to treat papilloma. Although there are problems of long treatment time and stenotic change on the ductal surface, this therapy is a valuable method to treat papilloma which could not be cured with non surgical treatment.