Purpose: Autofluorescence is an image enhancement technique used for detection of cancer precursor lesions in pulmonary and gastrointestinal endoscopy. This study evaluated the feasibility of addition of
autofluorescence to ductoscopy for the detection of breast cancer precursor lesions.

Methods: An autofluorescence imaging system, producing real-time computed images combining fluorescence intensities, was coupled to a conventional white light ductoscopy system. Prior to surgery, ductoscopy with white light and autofluorescence was evaluated under general anaesthesia in women scheduled for therapeutic or prophylactic mastectomy. Endoscopic findings in both modes
were compared, marked and correlated with histology of the surgical specimen.

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Results: Four breast cancer patients and four high-risk women, with a median age of 47 years (range, 23-62) were included. In autofluorescence mode two intraductal lesions were seen in two breast cancerpatients, which had an increase in the red-to-green fluorescence intensity compared with the surrounding tissue. One lesion had initially been missed by white light ductoscopy, but was clearly visible in subsequent autofluorescence mode. One endoscopic finding was classified as suspicious by white light, but was negative in autofluorescence mode with normal histology.