Abstract
The case involved a 73-year-old woman complaining of bloody discharge from her right nipple for over twenty years. Smear cytology indicated that the nipple discharge was class III b. We diagnosed her with category 1 breast via mammography. Ultrasonography indicated a hypoechoic mass lesion, 10×3×4 mm in size, and mammary duct dilatation within the lateral region of E area of her right breast. MRI could not rule out a possibility of carcinoma spreading to the mammary ducts in AC area of the right breast. Duct lobular segmentectomy was performed for the diagnosis and therapy. Using indocyanine green (ICG) fluorescence for guidance, we identified the precise target segment requiring resection after injecting blue dye and ICG into the mammary ducts. Histopathological diagnosis indicated that the patient had invasive ductal carcinoma with a predominant intraductal component. Furthermore, the resected specimen was classified as T1, N0, M0, stage I, surgical margin-negative, ER-positive, and PgR-positive. She was treated postoperatively with radiation therapy and an oral aromatase inhibitor. The method described herein is safe and can be used to observe the target segment of the mammary duct lesion in real time.
