SynthesisBreast cancer research and treatment2021
Meta-analysis and cost-effectiveness of ductoscopy, duct excision surgery and MRI for the diagnosis and treatment of patients with pathological nipple discharge.
Synthesis in Breast cancer research and treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic Accuracy of Magnetic Resonance Imaging Features and Tumor-to-Nipple Distance for the Nipple-Areolar Complex Involvement of Breast Cancer: A Systematic Review and Meta-Analysis.Korean journal of radiology · 2023Pooled it
- Ductoscopy Facilitates Surgical Decision-Making in Management of Patients with Pathological Nipple Discharge.Diagnostics (Basel, Switzerland) · 2026Article
- Transaxillary three-dimensional endoscopic segmental ductal resection for pathological nipple discharge: a case report.Frontiers in medicine · 2026Article
- Intraductal laser ablation during ductoscopy in patients with pathological nipple discharge.Breast cancer research and treatment · 2025Article
- An update on multimodal imaging strategies for nipple discharge: from detection to decision.Insights into imaging · 2025Article
- Role of immediate injection of methylene blue after fiberoptic ductoscopy in selective ductectomy for patients with pathological nipple discharge.BMC cancer · 2025Article
- Breast ductography: to do or not to do? A pictorial essay.Insights into imaging · 2023Review
- The Use of MRI to Detect Malignancy in a Patient Presenting With Unilateral Bloody Nipple Discharge.Cureus · 2023Article
- What is the role of breast MRI in the management of women with pathologic nipple discharge and normal conventional imaging?Irish journal of medical science · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPathological nipple discharge (PND) is a common breast-related complaint for referral to a surgical breast clinic because of its association with breast cancer. The aim of this meta-analysis was to compare the diagnostic efficacy of magnetic resonance imaging (MRI) and ductoscopy in patients with PND. Additionally, we determined the most cost-efficient strategy for the treatment of PND and the detection of breast cancer in PND patient without radiological suspicion for malignancy. MATERIALS AND
methodsPubMed and EMBASE were searched to collect the relevant literature from the inception of both diagnostic methods until January 27th 2020. The search yielded 815 original citations, of which 10 studies with 894 patients were finally included for analysis. Costs of ductoscopy, MRI and duct excision surgery were obtained from the UMC Utrecht as established in the year 2019. These costs included: medical personnel, overhead costs, material costs and sterilisation costs.
resultsThe meta-analysis showed no significant difference in sensitivity between ductoscopy (44%) and MRI (76%) for the detection of malignancy in patients with PND. However, ductoscopy (98%) had a statistically significantly higher specificity than MRI (84%). Individual costs were €1401.33, €822.13 and €6494.27 for ductoscopy, MRI and duct excision surgery, respectively. Full diagnostic strategy involving ductoscopy was on average €1670.97, while with MRI it was €2070.27.
conclusionPatients undergoing MRI are more often (false) positive which more often leads to duct excision surgery referrals compared to ductoscopy. This makes ductoscopy significantly more cost-effective compared MRI in patients with PND without radiological suspicion for malignancy.
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