{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T23:32:41Z","timestamp":1773444761428,"version":"3.50.1"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2016,3,23]],"date-time":"2016-03-23T00:00:00Z","timestamp":1458691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,4,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Invasive surgery remains the standard for diagnosis of pathological nipple discharge (PND). Only a minority of patients with nipple discharge and an unsuspicious finding on conventional breast imaging have cancer. Ductoscopy is a minimally invasive alternative for evaluation of PND. This systematic review and meta-analysis was designed to evaluate the diagnostic accuracy of ductoscopy in patients with PND.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A systematic search of electronic databases for studies addressing ductoscopy in patients with PND was conducted. Two classification systems were assessed. For DSany, all visualized ductoscopic abnormalities were classified as positive, whereas for DSsusp, only suspicious findings were considered positive. After checking heterogeneity, pooled sensitivity and specificity of DSany and DSsusp were calculated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The search yielded 4642 original citations, of which 20 studies were included in the review. Malignancy rates varied from 0 to 27 per cent. Twelve studies, including 1994 patients, were eligible for meta-analysis. Pooled sensitivity and specificity of DSany were 94 (95 per cent c.i. 88 to 97) per cent and 47 (44 to 49) per cent respectively. Pooled sensitivity and specificity of DSsusp were 50 (36 to 64) and 83 (81 to 86) per cent respectively. Heterogeneity between studies was moderate to large for sensitivity (DSany: I2 = 17\u00b75 per cent; DSsusp: I2 = 37\u00b79 per cent) and very large for specificity (DSany: I2 = 96\u00b78 per cent; DSsusp: I2 = 92\u00b76 per cent).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Ductoscopy detects about 94 per cent of all underlying malignancies in patients with PND, but does not permit reliable discrimination between malignant and benign findings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.10125","type":"journal-article","created":{"date-parts":[[2016,3,23]],"date-time":"2016-03-23T11:07:15Z","timestamp":1458731235000},"page":"632-643","source":"Crossref","is-referenced-by-count":29,"title":["Systematic review and meta-analysis of the diagnostic accuracy of ductoscopy in patients with pathological nipple discharge"],"prefix":"10.1093","volume":"103","author":[{"given":"L","family":"Waaijer","sequence":"first","affiliation":[{"name":"Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J M","family":"Simons","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I H M","family":"Borel Rinkes","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P J","family":"van Diest","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H M","family":"Verkooijen","sequence":"additional","affiliation":[{"name":"Imaging Division, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A J","family":"Witkamp","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2016,3,23]]},"reference":[{"key":"2021021915583954400_bjs10125-bib-0001","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1136\/bmj.309.6956.722","article-title":"ABC of Breast Diseases. 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