I'd like to fill in a little if I may ......
There is a significant difference between ductoscopy, where a fiberoptic scope is used for visualization, and ductal lavage to collect cell samples. Ductoscopy has been with us for a while but in it's early days when fiber optic scopes were much less sophisticated than they are today, it was a procedure that was done under general anesthetic. Though it was more of an experimental procedure at the time. Today's modern fiber optic scopes allow the procedure to be done under local topical anesthesia and for some, a mild oral anti-anxiety medication like ativan would be appropriate to use but the need would be on a case by case basis.
Ductal lavage was developed by Dr Susan Love in the past 10 years or so and has probably been widely available in the clinical areas for about the last 4-5 years. I'm not sure it has fallen out of favor as you have suggested but I would be hesitant to say that you are wrong about that either. There have been other successive variants that rely only on suction
only to collect fluid samples for cytology and I'm sure that there are others in development. The whole point being to collect cells from nipple discharge for cyto examination. Sometimes moist heat packs are applied to the breast and or the affected breast is vigorously massaged before trying to collect a sample. There is some information on the net for those interested. Do a google search for "ductal lavage"
As for not being a procedure for the play environment you are probably right though some people who were/are medical professionals (I am an RN) it is within the realm of the doable but for certain, it is a delicate procedure that requires a sensitive touch and most certainly visual aid e.g. magnifying headband. And with anything like this only the right types of supplies and equipment like normal saline for IV administeration (tap water, DIY stuff like salt water or contact lens fluid is unacceptable for this use .. please don't use that stuff) but I have done it in the play environment with the proviso's that I have stated. The catheter size used is about 30 ga.
I respect your knowledge on this subject .. it was coherent, I just wanted to add to it.
Warmest Regards
Will