Microdochectomy, also known as Subareolar Duct Excision, is a surgical procedure aimed at removing abnormal ducts within the breast. These abnormal ducts often harbor tumor cells which maybe precancerous or cancerous cells, posing a risk for disease progression if left untreated. Microdochectomy targets these specific ducts while preserving the surrounding healthy breast tissue, thus offering a conservative yet effective treatment option.

Who Needs Microdochectomy?

Microdochectomy may be recommended for individuals who:

• Have been diagnosed with precancerous or early-stage breast lesions confined to the ductal system (such as ductal carcinoma in situ (DCIS) or atypical ductal hyperplasia(ADH)).

• Have persistent nipple discharge associated with abnormal ductal findings on imaging studies.

• Have persistent blood-stained nipple discharge even without any abnormal imaging.

Procedure of Microdochectomy:

• Preoperative Assessment: Before undergoing microdochectomy, patients typically undergo a thorough preoperative assessment, which may include imaging studies such as mammography or breast ultrasound to precisely locate the affected duct or area of concern.

• Anesthesia: The procedure is performed under general anesthesia to ensure the patient's comfort and safety throughout the surgery.

• Incision: The surgeon makes a small incision around the areola or nipple area to access the affected duct or ducts.

• Duct Excision: Using precise surgical instruments, the surgeon carefully removes the targeted segment of the milk duct, ensuring complete excision of any suspicious or abnormal tissue.

• Closure: Once the duct excision is complete, the incision is meticulously closed using sutures or surgical staples.

• Recovery: Following the procedure, patients are monitored closely in the recovery room before being discharged home. Recovery time varies depending on individual factors but typically involves minimal discomfort and a quick return to normal activities.

Benefits of Microdochectomy:

• Breast Preservation: One of the primary advantages of microdochectomy is its focus on preserving the natural appearance and function of the breast. By selectively removing the affected duct/s while leaving the surrounding tissue intact, microdochectomy offers a conservative alternative to complete nipple areola removal and mastectomy.

• Reduced Risk of Complications: Compared to more extensive surgical procedures such as mastectomy, microdochectomy is associated with a lower risk of complications such as infection, hematoma and seroma formation.

• Improved Cosmesis: The small incision made during microdochectomy results in minimal scarring, contributing to improved cosmetic outcomes and patient satisfaction.

• Preservation of Breastfeeding Function: For women of childbearing age, microdochectomy may preserve the ability to breastfeed by minimizing disruption to the other lactiferous ducts responsible for milk production.

• Early Detection and Treatment: Microdochectomy allows for the precise removal and examination of suspicious or abnormal tissue, facilitating early detection and treatment of breast cancer.

Microdochectomy represents a valuable tool in the armamentarium of breast cancer treatment, offering patients a conservative yet effective alternative to more extensive surgical interventions. By combining precise surgical techniques with a focus on breast preservation,in select patients, microdochectomy exemplifies the evolving landscape of personalized medicine in the field of breast oncology.