LOCALIZATION OF INTRADUCTAL MASS THROUGH THE OSTIUM OF THE DUCT USING WIRE GUIDED DUCTOGRAPHY TECHNIQUE
To localize intraductal mass (Papilloma) before surgery
Guide wire 10-15 cm length of 2/3-0 Prolene/Surgipro
Plastic 26G to 20G I/V cannulas
Kopans breast lesion localization hook wire
Disposable syringe heaving 2ml non-ionic contrast
High intensity light and magnified glass.
METHODS:Prepare patient in sitting or lying position adjust high intensity light clean the nipple with antiseptic lotion. Elicit the discharge with gentle periareolar pressure or ask the patient to bring the discharge. If the opening with discharge is not clearly visualize use magnified glass or loop. Slowly inserted the wire into the duct orifice, it should pass freely into the duct. Introduce the 26G I/V plastic cannula coaxially over the guide wire and remove the guide wire. Gently inject 0.2-0.4 ml contrast, remove and the syringe and apply stopper. The cannula stopper assembly is secured to the breast with tape. Magnified craniocaudal view of the breast is taken, the 26G cannula removed and bigger length 22/20G cannula gradually passed over the guide wire according to distance of lesion from the ostium. Intraductal mass location is verified the hook wire is replaced with guide wire, the position of hook confirmed by mammographic film. The wire is cut 2cms from the nipple and pt. send to operation theater
Hook localization has been successfully carried out in six patients.
This is a new method of localization of intraductal mass it enables the surgeon to do microductectomy with minimal cosmetic effects to the breast.
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