- Email: [email protected]
P0112 Role of neoadjuvant chemotherapy in locally advanced nasopharyngeal carcinoma
e40
Abstracts / 50 (2014) e1–e74
vegetables, fruit juice, yogurt, tea, and vegetable salad significantly reduced the incidence and relative risk of stomach cancer (p < 0.05). Interpretation: There is a need to emphasise change of dietary beliefs and practices in all Omani families, with the strong focus on food habits, which may lower the risk of stomach cancer.
http://dx.doi.org/10.1016/j.ejca.2014.03.153
P0110 CHANGES IN QUALITY OF LIFE AND SYMPTOM EXPERIENCE IN BREAST CANCER PATIENTS WITH ADJUVANT TREATMENT J.H. Park a,*, Y.M. Jung a, S.H. Bae b. a Ajou University, South Korea, Dong-A University, South Korea
b
Background: Women diagnosed with breast cancer face significant side-effects such as nausea, vomiting, hair loss, and cognitive impairment and emotional distress due to aggressive adjuvant treatment. These side-effects adversely affect quality of life and symptom experience. The purpose of the study was to describe how quality of life and symptom experience develops over time in breast cancer patients undergoing adjuvant chemotherapy and radiotherapy. Methods: The study group was 113 women who had surgery and scheduled for adjuvant chemotherapy (n = 71) or radiotherapy (n = 42). Patients were assessed with quality of life (Functional Assessment of Cancer Therapy for Breast Cancer) and symptom experience (Memorial Symptom Assessment Scale-Short Form) before chemotherapy or radiotherapy (pretest), after chemotherapy or radiotherapy (post-test), and 6 months after chemotherapy or radiotherapy (followup test). Analysis of variance of repeated measures was used to investigate the change in quality of life and symptom experience in two groups. Findings: Patients receiving chemotherapy showed a significant increase in overall symptoms and physical symptoms between baseline and post-test. Overall quality of life, physical well-being, emotional well-being, and breast cancer specific domain decreased from pretest to post-test in the chemotherapy group but increased from post-test to the follow-up test. By contrast, there were no significant changes in symptom experience for the patients receiving radiotherapy. Significant increases were seen in overall quality of life, physical well-being, emotional well-being and breast cancer specific domain from baseline to follow-up test in patients receiving radiotherapy. Interpretation: When considering the substantial increase in life expectancy in persons with breast cancer, nursing practice and research should focus on quality of life and provide interventions to improve symptom experience and quality of life.
http://dx.doi.org/10.1016/j.ejca.2014.03.154
P0111 VOLTAGE-GATED K+ CHANNELS AS POTENTIAL THERAPEUTIC TARGETS FOR LUNG CANCER THERAPY S.H. Jang, S.Y. Choi, W.I. Jeon, P.D. Ryu, S.Y. Lee *. Laboratory of Veterinary Pharmacology, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
Background: Voltage-gated K+ (kV) channels are considered to be a regulator of membrane potential and cell excitability. Recently, evidence has indicated that several kV channel subtypes contribute to the control of cell proliferation in various types of cancer cells and are worthy of investigation as molecular targets for cancer therapy. Methods: We investigated the effects of the dendrotoxin-j (DTX-j) and margatoxin (MgTX) which are Kv1.1 and Kv1.3 specific blockers, respectively, on tumour formation using a xenograft model induced by A549 and H460 cells. Findings: The mRNA and protein of Kv1.1 and Kv1.3 was expressed in A549 and H460 cells and the blockade of Kv1.1 by DTX-j or Kv1.3 by MgTX reduced the formation of tumours in nude mice. Furthermore, treatment with DTX-j significantly increased the protein expression of p21Waf1/Cip1, p27Kip1, and p15INK4B, and significantly decreased the protein expression of cyclin D3 in tumour tissues compared to control. In addition, selective inhibition of Kv1.3 significantly increased expression level of p21Waf1/Cip1 and significantly decreased the expression level of Cdk4 and cyclin D3. Moreover, we found that the effect of DTX-j and gefitinib was synergistic in H460 and A549 cells. Interpretation: These results suggest that certain kV channels may serve as novel therapeutic targets for lung cancer therapy and could be one of multiple molecular targets to overcome tyrosine kinase inhibitor resistance. This work is supported by National Research Foundation of Korea (2012R1A2A2A01047151).
http://dx.doi.org/10.1016/j.ejca.2014.03.155
P0112 ROLE OF NEOADJUVANT CHEMOTHERAPY IN LOCALLY ADVANCED NASOPHARYNGEAL CARCINOMA M. Qasim Buriro *, R. Abdullah, H. Nisar . Pakistan Institute of Engineering and Applied Sciences Nilore, Islamabad, Pakistan Background: We evaluated the short-term efficacy and acute toxicities of neoadjuvant chemotherapy (cisplatin and fluorouracil) for locally advanced (stage II–IVB) nasopharyngeal carcinoma, from 1st November 2012 to 31st May 2013, at the Institute of Nuclear Medicine and Oncology Lahore (INMOL). International clinical studies of neoadjuvant chemotherapy in management of nasopharyngeal carcinoma (NPC) are still lacking. Methods: Fourteen patients with stage T3–4/N + M0 (stage II– IVB) nasopharyngeal carcinoma diagnosed histopathologically underwent baseline physical examination, appropriate laboratory tests, bone scan, and radiological imaging (chest X-ray, ultrasound of the abdomen, CT/MRI of the face and neck). The patients received two cycles of cisplatin 75 mg/m2 and fluorouracil 1000 mg/m2, day 1 and day 1 to day 5, every 3 weeks as neoadjuvant chemotherapy. Patients were assessed by appropriate laboratory tests on every 10th and 20th day of each cycle of chemotherapy. CT/MRI images were done after 3 weeks of completion of the second cycle of chemotherapy and were compared with baseline imaging for response evaluation. Findings: All patients completed two cycles of neoadjuvant chemotherapy. Major toxicities were non-haematological—vomiting and diarrhoea were seen in 50% of patients—and haematological—anaemia and leucopenia were seen in 43% patients. Ten (72%) of 14 patients showed a partial response in the primary tumour; the remaining four patients (28%) had stable disease. Seven (50%) patients had a complete nodal response; one patient who was N0 at baseline remained as N0 at follow-up, and one patient had stable nodal disease. Partial
Abstracts / 50 (2014) e1–e74
downstaging of disease occurred in 12 (86%) patients; two (14%) patients had stable disease. Interpretation: Neoadjuvant chemotherapy with cisplatin and fluorouracil shows short-term efficacy for locally advanced nasopharyngeal carcinoma; acute toxicities were easily managable.
http://dx.doi.org/10.1016/j.ejca.2014.03.156
P0115 SURVIVAL OF PATIENTS WITH NASOPHARYNGEAL CANCER: A NATIONWIDE DATA ANALYSIS IN TAIWAN W.-Y. Huang a, C.-H. Kao b, Y.-M. Jen a, C.-L. Lin c. a Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, b Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan, c Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan Background: Nasopharyngeal cancer (NPC) is endemic in Taiwan. Using a nationwide population-based data, we reported the contemporary survival outcome of patients with NPC and analysed the factors affecting survival. Methods: This retrospective cohort study used the Taiwan National Health Insurance Research Database, which covers approximately 99% of the population of over 23.74 million people in Taiwan. We identified 13,407 patients with newly diagnosed NPC during 2002– 2010. We used the Kaplan–Meier method to compare the probability of survival among different groups and log-rank test was used to examine the differences. We calculated hazard ratios (HRs) and 95% confidence interval (CI) using Cox hazard proportional model to assess the hazard ratio of mortality in NPC patients. Multivariate Cox hazard proportional model was used to measure the mortality-association risk factor in NPC patients after adjustment for NPC treatment and sociodemographic characteristics. Findings: Among 13,407 NPC patients, 74.9% were male. The mean age at diagnosis was 50.5 years. Overall 1-, 2-, 5-, and 8-year survival rates were 89.6%, 80.4%, 65.2%, and 56.5%, respectively. The mean and median survival times were 3.38 and 2.83 years, respectively. Female patients had lower 1- and 5-year relative excess risk of mortality than male patients (1- and 5-year survival rates: 91.5% and 71.1% versus 88.9% and 63.3%; p < 0.001). The factors were associated with increased risk of mortality were male gender (HR 1.45, 95% CI 1.34–1.56), older age (HR 3.61, 95% CI 3.25–4.00), residing in eastern Taiwan (HR 1.39, 95% CI 1.25–1.54), low income (HR 1.87, 95% CI 1.69–2.07), and receiving chemotherapy alone (HR 2.25, 95% CI 1.97–2.57). Interpretation: The contemporary 8-year overall survival rate for patients with NPC in Taiwan was 56.5%. Male patients, old age, residing in eastern Taiwan, low income, and receiving chemotherapy alone were independent predictors for poor overall survival in patients with NPC in Taiwan.
http://dx.doi.org/10.1016/j.ejca.2014.03.159
P0116 SAFETY OF WEEKLY ADMINISTRATION OF NANOPARTICLE ALBUMIN-BOUND PACLITAXEL IN PATIENTS WITH BREAST CANCER
e41
H. Seki, F. Asanuma, Y. Yamada, Y. Hirata, M. Kaneda, K. Suzuki, M. Osaku. Department of Surgery, Breast Center, Kitasato University, Kitasato Institute Hospital, Tokyo, Japan Background: Nanoparticle albumin-bound (nab) paclitaxel is reported to be highly effective; however, in a Japanese Post-marketing Safety Evaluation of 943 patients a high incidence of myelosuppression, peripheral neuropathy, and myalgia was observed. In patients undergoing two cycles of continuous administration of nab-paclitaxel, the rates of dose reduction and treatment discontinuation were reported to be 27.3% and 24.6%, respectively. The objective of this study is to confirm the safety of weekly nab-paclitaxel in patients with breast cancer. Methods: We enrolled 14 patients with breast cancer at our hospital, who received weekly nab-paclitaxel (80 mg/m2) for 3 consecutive weeks followed by a 1-week wash-out period from May until December 2012. Findings: The incidence of adverse events and the number of patients who experienced these events were as follows: leucopenia (G1/2, 42.8%; G3/4, 0%) in six patients, haemoglobin decreased (G1/2, 21.4%; G3/4, 0%) in three patients, thrombocytopenia (G1/2, 7.1%; G3/4, 0%) in one patient, hepatic dysfunction (G1/2, 28.6%; G3/4, 0%) in four patients, diarrhoea (G1/2, 28.6%; G3/4, 0%) in four patients, constipation (G1/2, 21.4%; G3/4, 0%) in three patients, nausea (G1/2, 35.7%; G3/4, 0%) in five patients, stomatitis (G1/2, 71.4%; G3/4, 0%) in 10 patients, anorexia (G1/2, 7.1%; G3/4, 7.1%) in four patients, oedema (G1/2, 28.6%; G3/4, 0%) in four patients, arthralgia (G1/2, 35.7%; G3/4, 0%) in five patients, myalgia (G1/2, 21.4%; G3/4, 0%) in three patients, peripheral neuropathy (G1/2, 57.2%; G3/4, 0%) in eight patients, malaise (G1/2, 64.3%; G3/4, 0%) in nine patients, and interstitial pneumonia (G1/2, 0%; G3/4, 7.1%) in one patient. No dose reductions were reported, and nab-paclitaxel treatment was only discontinued in one patient due to the occurrence of interstitial pneumonia. Interpretation: In patients with breast cancer, weekly nab-paclitaxel was probably less toxic than those of the previously reported regimen of nab-paclitaxel once every 3 weeks. http://dx.doi.org/10.1016/j.ejca.2014.03.160
P0117 MAMMARY DUCTOSCOPY COMBINED WITH DUCTAL LAVAGE IN PATIENTS WITH PATHOLOGICAL NIPPLE DISCHARGE I. Popov, G. Baitchev. Department of Thoracic Surgery, MMA, Sofia, Bulgaria, Department of Surgery, Oncological Hospital, Veliko Tarnovo, Bulgaria Background: Pathological nipple discharge is diagnosed clinically and usually managed by diagnostic duct excision. Because most nipple discharge is a result of benign processes, less invasive, non-surgical diagnostic modalities have been explored to reduce the need for surgical intervention. The aim of this study to analyse the diagnostic possibilities of mammary ductoscopy combined with ductal lavage in patients with pathological nipple discharge. Methods: A total of 38 patients with nipple discharge and normal mammographic and US evaluation prospective underwent ductal lavage and mammary endoscopy. We used local anaesthetic to induct the lacrimal dilatators (diameter 0.35 to 1.00 mm, from which we infuse and aspirate 7 to 18 mL 1% lidocaince and 0.9% NaCl) through the opening of the secreting cannal. Endoscopy with mammary ductoscope was then done with Karl-Storz endoscope with an outside diameter of 0.89 mm.
Abstracts / 50 (2014) e1–e74
vegetables, fruit juice, yogurt, tea, and vegetable salad significantly reduced the incidence and relative risk of stomach cancer (p < 0.05). Interpretation: There is a need to emphasise change of dietary beliefs and practices in all Omani families, with the strong focus on food habits, which may lower the risk of stomach cancer.
http://dx.doi.org/10.1016/j.ejca.2014.03.153
P0110 CHANGES IN QUALITY OF LIFE AND SYMPTOM EXPERIENCE IN BREAST CANCER PATIENTS WITH ADJUVANT TREATMENT J.H. Park a,*, Y.M. Jung a, S.H. Bae b. a Ajou University, South Korea, Dong-A University, South Korea
b
Background: Women diagnosed with breast cancer face significant side-effects such as nausea, vomiting, hair loss, and cognitive impairment and emotional distress due to aggressive adjuvant treatment. These side-effects adversely affect quality of life and symptom experience. The purpose of the study was to describe how quality of life and symptom experience develops over time in breast cancer patients undergoing adjuvant chemotherapy and radiotherapy. Methods: The study group was 113 women who had surgery and scheduled for adjuvant chemotherapy (n = 71) or radiotherapy (n = 42). Patients were assessed with quality of life (Functional Assessment of Cancer Therapy for Breast Cancer) and symptom experience (Memorial Symptom Assessment Scale-Short Form) before chemotherapy or radiotherapy (pretest), after chemotherapy or radiotherapy (post-test), and 6 months after chemotherapy or radiotherapy (followup test). Analysis of variance of repeated measures was used to investigate the change in quality of life and symptom experience in two groups. Findings: Patients receiving chemotherapy showed a significant increase in overall symptoms and physical symptoms between baseline and post-test. Overall quality of life, physical well-being, emotional well-being, and breast cancer specific domain decreased from pretest to post-test in the chemotherapy group but increased from post-test to the follow-up test. By contrast, there were no significant changes in symptom experience for the patients receiving radiotherapy. Significant increases were seen in overall quality of life, physical well-being, emotional well-being and breast cancer specific domain from baseline to follow-up test in patients receiving radiotherapy. Interpretation: When considering the substantial increase in life expectancy in persons with breast cancer, nursing practice and research should focus on quality of life and provide interventions to improve symptom experience and quality of life.
http://dx.doi.org/10.1016/j.ejca.2014.03.154
P0111 VOLTAGE-GATED K+ CHANNELS AS POTENTIAL THERAPEUTIC TARGETS FOR LUNG CANCER THERAPY S.H. Jang, S.Y. Choi, W.I. Jeon, P.D. Ryu, S.Y. Lee *. Laboratory of Veterinary Pharmacology, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
Background: Voltage-gated K+ (kV) channels are considered to be a regulator of membrane potential and cell excitability. Recently, evidence has indicated that several kV channel subtypes contribute to the control of cell proliferation in various types of cancer cells and are worthy of investigation as molecular targets for cancer therapy. Methods: We investigated the effects of the dendrotoxin-j (DTX-j) and margatoxin (MgTX) which are Kv1.1 and Kv1.3 specific blockers, respectively, on tumour formation using a xenograft model induced by A549 and H460 cells. Findings: The mRNA and protein of Kv1.1 and Kv1.3 was expressed in A549 and H460 cells and the blockade of Kv1.1 by DTX-j or Kv1.3 by MgTX reduced the formation of tumours in nude mice. Furthermore, treatment with DTX-j significantly increased the protein expression of p21Waf1/Cip1, p27Kip1, and p15INK4B, and significantly decreased the protein expression of cyclin D3 in tumour tissues compared to control. In addition, selective inhibition of Kv1.3 significantly increased expression level of p21Waf1/Cip1 and significantly decreased the expression level of Cdk4 and cyclin D3. Moreover, we found that the effect of DTX-j and gefitinib was synergistic in H460 and A549 cells. Interpretation: These results suggest that certain kV channels may serve as novel therapeutic targets for lung cancer therapy and could be one of multiple molecular targets to overcome tyrosine kinase inhibitor resistance. This work is supported by National Research Foundation of Korea (2012R1A2A2A01047151).
http://dx.doi.org/10.1016/j.ejca.2014.03.155
P0112 ROLE OF NEOADJUVANT CHEMOTHERAPY IN LOCALLY ADVANCED NASOPHARYNGEAL CARCINOMA M. Qasim Buriro *, R. Abdullah, H. Nisar . Pakistan Institute of Engineering and Applied Sciences Nilore, Islamabad, Pakistan Background: We evaluated the short-term efficacy and acute toxicities of neoadjuvant chemotherapy (cisplatin and fluorouracil) for locally advanced (stage II–IVB) nasopharyngeal carcinoma, from 1st November 2012 to 31st May 2013, at the Institute of Nuclear Medicine and Oncology Lahore (INMOL). International clinical studies of neoadjuvant chemotherapy in management of nasopharyngeal carcinoma (NPC) are still lacking. Methods: Fourteen patients with stage T3–4/N + M0 (stage II– IVB) nasopharyngeal carcinoma diagnosed histopathologically underwent baseline physical examination, appropriate laboratory tests, bone scan, and radiological imaging (chest X-ray, ultrasound of the abdomen, CT/MRI of the face and neck). The patients received two cycles of cisplatin 75 mg/m2 and fluorouracil 1000 mg/m2, day 1 and day 1 to day 5, every 3 weeks as neoadjuvant chemotherapy. Patients were assessed by appropriate laboratory tests on every 10th and 20th day of each cycle of chemotherapy. CT/MRI images were done after 3 weeks of completion of the second cycle of chemotherapy and were compared with baseline imaging for response evaluation. Findings: All patients completed two cycles of neoadjuvant chemotherapy. Major toxicities were non-haematological—vomiting and diarrhoea were seen in 50% of patients—and haematological—anaemia and leucopenia were seen in 43% patients. Ten (72%) of 14 patients showed a partial response in the primary tumour; the remaining four patients (28%) had stable disease. Seven (50%) patients had a complete nodal response; one patient who was N0 at baseline remained as N0 at follow-up, and one patient had stable nodal disease. Partial
Abstracts / 50 (2014) e1–e74
downstaging of disease occurred in 12 (86%) patients; two (14%) patients had stable disease. Interpretation: Neoadjuvant chemotherapy with cisplatin and fluorouracil shows short-term efficacy for locally advanced nasopharyngeal carcinoma; acute toxicities were easily managable.
http://dx.doi.org/10.1016/j.ejca.2014.03.156
P0115 SURVIVAL OF PATIENTS WITH NASOPHARYNGEAL CANCER: A NATIONWIDE DATA ANALYSIS IN TAIWAN W.-Y. Huang a, C.-H. Kao b, Y.-M. Jen a, C.-L. Lin c. a Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, b Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan, c Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan Background: Nasopharyngeal cancer (NPC) is endemic in Taiwan. Using a nationwide population-based data, we reported the contemporary survival outcome of patients with NPC and analysed the factors affecting survival. Methods: This retrospective cohort study used the Taiwan National Health Insurance Research Database, which covers approximately 99% of the population of over 23.74 million people in Taiwan. We identified 13,407 patients with newly diagnosed NPC during 2002– 2010. We used the Kaplan–Meier method to compare the probability of survival among different groups and log-rank test was used to examine the differences. We calculated hazard ratios (HRs) and 95% confidence interval (CI) using Cox hazard proportional model to assess the hazard ratio of mortality in NPC patients. Multivariate Cox hazard proportional model was used to measure the mortality-association risk factor in NPC patients after adjustment for NPC treatment and sociodemographic characteristics. Findings: Among 13,407 NPC patients, 74.9% were male. The mean age at diagnosis was 50.5 years. Overall 1-, 2-, 5-, and 8-year survival rates were 89.6%, 80.4%, 65.2%, and 56.5%, respectively. The mean and median survival times were 3.38 and 2.83 years, respectively. Female patients had lower 1- and 5-year relative excess risk of mortality than male patients (1- and 5-year survival rates: 91.5% and 71.1% versus 88.9% and 63.3%; p < 0.001). The factors were associated with increased risk of mortality were male gender (HR 1.45, 95% CI 1.34–1.56), older age (HR 3.61, 95% CI 3.25–4.00), residing in eastern Taiwan (HR 1.39, 95% CI 1.25–1.54), low income (HR 1.87, 95% CI 1.69–2.07), and receiving chemotherapy alone (HR 2.25, 95% CI 1.97–2.57). Interpretation: The contemporary 8-year overall survival rate for patients with NPC in Taiwan was 56.5%. Male patients, old age, residing in eastern Taiwan, low income, and receiving chemotherapy alone were independent predictors for poor overall survival in patients with NPC in Taiwan.
http://dx.doi.org/10.1016/j.ejca.2014.03.159
P0116 SAFETY OF WEEKLY ADMINISTRATION OF NANOPARTICLE ALBUMIN-BOUND PACLITAXEL IN PATIENTS WITH BREAST CANCER
e41
H. Seki, F. Asanuma, Y. Yamada, Y. Hirata, M. Kaneda, K. Suzuki, M. Osaku. Department of Surgery, Breast Center, Kitasato University, Kitasato Institute Hospital, Tokyo, Japan Background: Nanoparticle albumin-bound (nab) paclitaxel is reported to be highly effective; however, in a Japanese Post-marketing Safety Evaluation of 943 patients a high incidence of myelosuppression, peripheral neuropathy, and myalgia was observed. In patients undergoing two cycles of continuous administration of nab-paclitaxel, the rates of dose reduction and treatment discontinuation were reported to be 27.3% and 24.6%, respectively. The objective of this study is to confirm the safety of weekly nab-paclitaxel in patients with breast cancer. Methods: We enrolled 14 patients with breast cancer at our hospital, who received weekly nab-paclitaxel (80 mg/m2) for 3 consecutive weeks followed by a 1-week wash-out period from May until December 2012. Findings: The incidence of adverse events and the number of patients who experienced these events were as follows: leucopenia (G1/2, 42.8%; G3/4, 0%) in six patients, haemoglobin decreased (G1/2, 21.4%; G3/4, 0%) in three patients, thrombocytopenia (G1/2, 7.1%; G3/4, 0%) in one patient, hepatic dysfunction (G1/2, 28.6%; G3/4, 0%) in four patients, diarrhoea (G1/2, 28.6%; G3/4, 0%) in four patients, constipation (G1/2, 21.4%; G3/4, 0%) in three patients, nausea (G1/2, 35.7%; G3/4, 0%) in five patients, stomatitis (G1/2, 71.4%; G3/4, 0%) in 10 patients, anorexia (G1/2, 7.1%; G3/4, 7.1%) in four patients, oedema (G1/2, 28.6%; G3/4, 0%) in four patients, arthralgia (G1/2, 35.7%; G3/4, 0%) in five patients, myalgia (G1/2, 21.4%; G3/4, 0%) in three patients, peripheral neuropathy (G1/2, 57.2%; G3/4, 0%) in eight patients, malaise (G1/2, 64.3%; G3/4, 0%) in nine patients, and interstitial pneumonia (G1/2, 0%; G3/4, 7.1%) in one patient. No dose reductions were reported, and nab-paclitaxel treatment was only discontinued in one patient due to the occurrence of interstitial pneumonia. Interpretation: In patients with breast cancer, weekly nab-paclitaxel was probably less toxic than those of the previously reported regimen of nab-paclitaxel once every 3 weeks. http://dx.doi.org/10.1016/j.ejca.2014.03.160
P0117 MAMMARY DUCTOSCOPY COMBINED WITH DUCTAL LAVAGE IN PATIENTS WITH PATHOLOGICAL NIPPLE DISCHARGE I. Popov, G. Baitchev. Department of Thoracic Surgery, MMA, Sofia, Bulgaria, Department of Surgery, Oncological Hospital, Veliko Tarnovo, Bulgaria Background: Pathological nipple discharge is diagnosed clinically and usually managed by diagnostic duct excision. Because most nipple discharge is a result of benign processes, less invasive, non-surgical diagnostic modalities have been explored to reduce the need for surgical intervention. The aim of this study to analyse the diagnostic possibilities of mammary ductoscopy combined with ductal lavage in patients with pathological nipple discharge. Methods: A total of 38 patients with nipple discharge and normal mammographic and US evaluation prospective underwent ductal lavage and mammary endoscopy. We used local anaesthetic to induct the lacrimal dilatators (diameter 0.35 to 1.00 mm, from which we infuse and aspirate 7 to 18 mL 1% lidocaince and 0.9% NaCl) through the opening of the secreting cannal. Endoscopy with mammary ductoscope was then done with Karl-Storz endoscope with an outside diameter of 0.89 mm.