{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:00:03Z","timestamp":1790316003493,"version":"4.1.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pathological nipple discharge often requires surgery to remove the affected duct. The conventional circumareolar incisions are generally satisfactory but may result in local hypoesthesia or in ischemic necrosis of the nipple-areola complex because of neurovascular disruption. Therefore, alternative, minimally invasive techniques to reduce this structural damage are being investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 30-year-old woman presented with a history of serous unilateral nipple discharge for six months. Mammary ductoscopy indicated an intraductal space-occupying lesion, and this was then marked with precise intraductal staining with methylene blue. A three-dimensional endoscopic-assisted segmental ductal resection was performed through a small incision in the natural axillary fold, utilizing the posterior chest space. This particular technique aimed to prevent direct surgical trauma to the central areolar region. Histopathology and immunohistochemistry after surgery indicated the possibility of a benign intraductal papilloma. Patient's recovery was uneventful without complications. The clinical assessment indicated good maintenance of the papillary-areolar blood supply, no serious hypoesthesia of the skin, and no visible scarring of the breast surface.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The three-dimensional endoscopic-assisted axillary approach may be a useful and aesthetically favorable alternative for managing benign intraductal lesions. It may decrease local postoperative complications of traditional incisions, but more clinical studies are required to determine its wider application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1936119","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:33:41Z","timestamp":1790314421000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Transaxillary three-dimensional endoscopic segmental ductal resection for pathological nipple discharge: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Yi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Thyroid and Breast Surgery, The Affiliated Hospital of Panzhihua University","place":["Panzhihua, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery, The Affiliated Hospital of Panzhihua University","place":["Panzhihua, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyang","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery, The Affiliated Hospital of Panzhihua University","place":["Panzhihua, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery, The Affiliated Hospital of Panzhihua University","place":["Panzhihua, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery, The Affiliated Hospital of Panzhihua University","place":["Panzhihua, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery, The Affiliated Hospital of Panzhihua University","place":["Panzhihua, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S304","DOI":"10.1016\/j.jacr.2022.09.020","article-title":"ACR appropriateness criteria(R) evaluation of nipple discharge: 2022 update","volume":"19","author":"Sanford","year":"2022","journal-title":"J Am Coll Radiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"330","DOI":"10.2214\/AJR.19.22025","article-title":"Nipple discharge: current clinical and imaging evaluation","volume":"216","author":"Gupta","year":"2021","journal-title":"AJR Am J Roentgenol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1007\/s13193-025-02263-2","article-title":"Determining the upgrade rate of de-novo breast intraductal papillomas to malignancy, its related risk factors, and 6-month outcome after treatment","volume":"17","author":"Aziminezhadan","year":"2026","journal-title":"Indian J Surg Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"8643","DOI":"10.1245\/s10434-021-10188-7","article-title":"Upgrade rate and predictive factors for breast benign intraductal papilloma diagnosed at biopsy: a meta-analysis","volume":"28","author":"Zhang","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1308\/rcsann.2022.0093","article-title":"Surgical outcomes of total duct excision in the diagnosis and management of nipple discharge","volume":"106","author":"Ward","year":"2024","journal-title":"Ann R Coll Surg Engl"},{"key":"B6","doi-asserted-by":"publisher","first-page":"zrad066","DOI":"10.1093\/bjsopen\/zrad066","article-title":"Role of duct excision surgery in the treatment of pathological nipple discharge and detection of breast carcinoma: systematic review","volume":"7","author":"Makineli","year":"2023","journal-title":"BJS Open"},{"key":"B7","doi-asserted-by":"publisher","first-page":"ojae090","DOI":"10.1093\/asjof\/ojae090","article-title":"Duplex study of the nipple-areola complex blood supply in the female breast","volume":"7","author":"Hosny","year":"2025","journal-title":"Aesthet Surg J Open Forum"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjag125","article-title":"Venous drainage and nipple-areolar complex necrosis after nipple-sparing mastectomy: a cadaveric and prospective clinical cohort study","author":"Yoon","year":"2026","journal-title":"Aesthet Surg J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"4697","DOI":"10.1007\/s00266-026-05681-x","article-title":"Comparing nipple and areola sensory outcomes and nerve-related complications using different incision types in breast augmentation: a scoping review","volume":"50","author":"Tulimat","year":"2026","journal-title":"Aesthetic Plast Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/s0007-1226(97)91155-3","article-title":"The cutaneous innervation of the female breast and nipple-areola complex: implications for surgery","volume":"50","author":"Jaspars","year":"1997","journal-title":"Br J Plast Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1157545","DOI":"10.3389\/fonc.2023.1157545","article-title":"Trans-axillary single port insufflation technique-assisted endoscopic surgery for breast diseases: clinic experience, cosmetic outcome and oncologic result","volume":"13","author":"Wang","year":"2023","journal-title":"Front Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"6319218","DOI":"10.1155\/tbj\/6319218","article-title":"Single-port three-dimensional endoscopic-assisted axillary lymph node dissection (S-P 3D E-ALND): surgical technique and preliminary results","volume":"2024","author":"Sae-Lim","year":"2024","journal-title":"Breast J"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1111\/ans.70537","article-title":"The learning curve of transaxillary endoscopy-assisted nipple-sparing mastectomy with immediate prepectoral implant-based breast reconstruction","volume":"96","author":"Lian","year":"2026","journal-title":"ANZ J Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2467046","DOI":"10.1155\/tbj\/2467046","article-title":"Effectiveness of duct excision procedures in detecting preneoplastic and malignant lesions in pathological nipple discharge: a retrospective cohort study","volume":"2025","author":"Ata","year":"2025","journal-title":"Breast J"},{"key":"B15","doi-asserted-by":"publisher","first-page":"866","DOI":"10.3348\/kjr.2021.0850","article-title":"The value of adding ductography to ultrasonography for the evaluation of pathologic nipple discharge in women with negative mammography","volume":"23","author":"Choi","year":"2022","journal-title":"Korean J Radiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s12880-025-01674-5","article-title":"Dual contrast-enhanced ultrasound for diagnosing pathologic nipple discharge associated with papillary lesions","volume":"25","author":"Zhao","year":"2025","journal-title":"BMC Med Imaging"},{"key":"B17","doi-asserted-by":"publisher","first-page":"106097","DOI":"10.1016\/j.humpath.2026.106097","article-title":"Upgrade risk in intraductal papillomas: a retrospective analysis of real-world data and predictive model development","volume":"172","author":"Kotola","year":"2026","journal-title":"Hum Pathol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"10081","DOI":"10.21037\/qims-2025-701","article-title":"Development and validation of a clinical-bimodal nomogram to predict the malignancy of pathologic nipple discharge","volume":"15","author":"Mei","year":"2025","journal-title":"Quant Imaging Med Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1007\/s10549-021-06094-x","article-title":"Meta-analysis and cost-effectiveness of ductoscopy, duct excision surgery and MRI for the diagnosis and treatment of patients with pathological nipple discharge","volume":"186","author":"Filipe","year":"2021","journal-title":"Breast Cancer Res Treat"},{"key":"B20","doi-asserted-by":"publisher","first-page":"7783","DOI":"10.1007\/s00330-021-07790-4","article-title":"Diagnostic accuracy of breast MRI for patients with suspicious nipple discharge and negative mammography and ultrasound: a prospective study","volume":"31","author":"Boisserie-Lacroix","year":"2021","journal-title":"Eur Radiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1159\/000530817","article-title":"A second ductoscopy procedure in patients with recurrent and persistent pathological nipple discharge","volume":"18","author":"Makineli","year":"2023","journal-title":"Breast Care (Basel)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s12282-020-01184-y","article-title":"Patient-reported outcomes of ductoscopy procedures for pathologic nipple discharge","volume":"28","author":"Filipe","year":"2021","journal-title":"Breast Cancer"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1103145","DOI":"10.3389\/fonc.2023.1103145","article-title":"Deep learning for real-time detection of breast cancer presenting pathological nipple discharge by ductoscopy","volume":"13","author":"Xu","year":"2023","journal-title":"Front Oncol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1936119\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:33:41Z","timestamp":1790314421000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1936119\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":23,"alternative-id":["10.3389\/fmed.2026.1936119"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1936119","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,25]]},"article-number":"1936119"}}