A Case of Microdochectomy for Breast Cancer Using Three-Dimentional CT(3D-CT)Ductography for Determining the Resection Range

Abstract

A 45-year-old woman was admitted to our hospital because of bloody nipple secretion. Although mammograms did not recognize significant findings, mammary ultrasound showed enlargement of the duct of upper inside of the right breast, forming a solid mass about 1 cm in diameter in part. Ductography was performed for the purpose of identifying the extent of the lobe involved. After infusion of contrast medium into the duct, imagings with 3D-CT resulted in 3-dimentional depiction of the spread of the dilated duct in the mammary gland. Ductal lavage cytology was positive (Class V).

We made a suspected diagnosis of non-invasive ductal carcinoma with some invasive lesion and performed microdochectomy for biopsy to make the definitive diagnosis and treatment. The CT image was printed out on the actual size, the extent of the lesion was projected on the patient's body surface at the time of surgery, and it was used as a reference for determining the resection range. Non-invasive ductal carcinoma spreading widely and lesions that had partially invaded to become scirrhouscarcinoma could be centrally resected.

The 3D-CT appears to be an effective technique in performing microdochectomy for non-invasive ductal carcinoma in which the extent of the lesion is difficult to comprehend.