Using Microendoscopy to Diagnose Breast Cancer

Nicolas Beechey-Newman from Guy's Hospital (London, UK).

The endoscope can pass through the nipple to search for the early signs of cancer within the breast. The new technique is now being tested in a clinical trial. Although advances in fiber optics have produced endoscopes smaller than 1 mm across, these provide poor picture quality because they contain very few glass fibers. Researchers at Guy's Hospital worked with endoscope designers and manufacturers to develop a dilator and a modified lighting system. The result is a microendoscope ideally suited for examining the ducts in the breast.

Once passed through the openings at the tip of the nipple, the endoscope sends back magnified pictures of the inside of the breast duct to television screens where doctors can identify any warning signs. Abnormal areas have lost their shine and have changed to a reddish-pink color. Surgeons can then plot where the problem areas are before performing a biopsy or carrying out treatment. Although women now undergoing the procedure have a general anesthetic, in the future a local anesthetic may be all that is needed.

"In one patient who was having a prophylactic mastectomy we found a lesion close to the nipple that would undoubtedly have been missed by the pathologists,” said Dr. Beechey-Newman. "It turned out to be a 2 mm invasive cancer.” Premalignant changes are present for up to 10 years before invasive breast cancer develops, he noted, which are only infrequently seen by mammography.



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