Breast imaging in patients with nipple discharge

Paula, Ivie Braga de; Campos, Adriene Moraes

doi:10.1590/0100-3984.2016.0103

Cited by 28 publications

(22 citation statements)

References 30 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that second-look US after galactography showed high sensitivity for 'borderline and malignant lesions' (95.8%) and malignant lesions only (90%). Magnetic resonance imaging (MRI) is known as a highly sensitive technique for invasive breast cancer (68-100%) and DCIS (77-96%) detection [19,20]. Several studies have been conducted to evaluate the potential diagnostic role of MRI in ductal pathologies and have provided a comparative analysis between MRI and galactography [14,21,22].…”

Section: Discussionmentioning

confidence: 99%

Second-look breast ultrasonography after galactography in patients with nipple discharge

et al. 2020

View full text Add to dashboard Cite

Aim: The objective of this study was to evaluate the diagnostic performance of second-look breast ultrasound (US) immediately after galactography in patients with nipple discharge.Materials and methods: Between January 2010 and November 2018, 89 patients with nipple discharge were retrospectively analyzed. All patients were examined by galactography and US. US was performed twice, before and after galactography. Galactography, mammography and US findings were categorized according to the Breast Imaging Reporting and Data System (BI-RADS). The final diagnosis was established by histopathological examination.Results: Out of 89 patients, 25 (28.1%) patients had positive findings as evident by US before galactography. Forty-eight (53.9%) patients had positive findings as demonstrated by galactography. Fifty-nine (66.3%) patients had positive findings as evident by second-look US after galactography (13 patients with benign, 37 with borderline and 9 with malignant lesions). Second-look US after galactography showed the highest diagnostic accuracy (83.2%), sensitivity (95.8%) and negative predictive value (93.3%) for borderline and malignant lesions. For the detection of malignant lesions, secondlook US after galactography showed the highest sensitivity (90%) and negative predictive value (96.7%). Agreement between imaging and histological result using Bland-Altman analysis exhibited no significant difference between the size establishedby ultrasound and galactography.Conclusion: The second-look US after galactography is a powerful diagnostic tool for the detection of lesions in patients with nipple discharge and demonstrates high diagnostic accuracy, sensitivity and negative predictive value.

show abstract

Section: Discussionmentioning

confidence: 99%

Second-look breast ultrasonography after galactography in patients with nipple discharge

et al. 2020

View full text Add to dashboard Cite

show abstract

“…11,12 Therefore, the value of MRI is limited in patients with PND, and core needle biopsy or surgical excision is still indicated when MRI shows a suspicious lesion. 13,14 Because PND is regarded as a possible sign of breast cancer, and standard radiologic imaging often fails to reveal the underlying cause, most women suffering PND undergo surgical procedures, such as microdochectomy or major duct excision, to rule out malignancy. 8,10,11 These surgical procedures are performed under general anesthesia and are associated with scarring, which may result in breastfeeding difficulties in fertile women.…”

Section: Introductionmentioning

confidence: 99%

Interventional Ductoscopy as an Alternative for Major Duct Excision or Microdochectomy in Women Suffering Pathologic Nipple Discharge: A Single-center Experience

Filipe

Waaijer

Pol

et al. 2020

Clinical Breast Cancer

View full text Add to dashboard Cite

Ductoscopy is a minimally invasive technique that is currently used to detect, and sometimes remove, lesions that cause pathologic nipple discharge (PND). This study shows that ductoscopy is an alternative for surgery in patients with PND that have negative conventional imagery for breast cancer. Additionally, this study shows that ductoscopy has a high sensitivity, specificity, and negative predictive value for the detection of breast cancer in patients with PND with negative conventional imagery. Introduction: Pathologic nipple discharge (PND) is, after palpable lumps and pain, the most common breast-related reason for referral to the breast surgeon and is associated with breast cancer. However, with negative mammography and ultrasound, the chance of PND being caused by malignancy is between 5% and 8%. Nevertheless, most patients with PND still undergo surgery in order to rule out malignancy. Ductoscopy is a minimally invasive endoscopic technique that enables direct intraductal visualization. The aim of this study was to evaluate (interventional) ductoscopy as an alternative to surgery in patients with negative conventional imaging. Materials and Methods: All patients with PND referred between 2010 and 2017 to our hospital for ductoscopy were retrospectively analyzed. Ductoscopy procedures were performed under local anesthesia in the outpatient clinic. The follow-up period was at least 3 months, and the primary outcome was the number of prevented surgical procedures. Furthermore, we evaluated possible complications after ductoscopy (infection and pain). Results: A total of 215 consecutive patients undergoing ductoscopy were analyzed. In 151 (70.2%) patients, ductoscopy was successful. In 102 procedures, an underlying cause for PND was visualized, of which 34 patients could be histologically proven and 82 patients treated. Sixty of the 215 patients were eventually operated, 8 owing to suspicious findings during ductoscopy, 42 owing to persistent PND, and 10 because of recurrent PND. In 7 patients, a malignancy was found (5 of them classified as suspicious at dusctoscopy). No serious side effects were seen. Conclusion: Ductoscopy can be safely used as an alternative for surgery in the workup for PND.

show abstract

“…Our study found that benign diseases (74.2%) were the most common cause of pathologic nipple discharge, while we found high risk lesion and malignancy rate in (25.8%) of cases. Paula et al [8] reported that the most common causes of nipple discharge were some benign breast lesions, such as ductal ectasia, in 6-59% of cases, and papilloma, in 35-56%. The risk of underlying malignancy is not negligible, ranging from 5 to 23%.…”

Section: Discussionmentioning

confidence: 99%

MRI for assessment of pathologic nipple discharge: is it mandatory?

Zaky

Hafez

Zaky

et al. 2019

Egypt J Radiol Nucl Med

View full text Add to dashboard Cite

Background: Benign breast lesions is the most common cause of nipple discharge; however, a rare but major cause is breast cancer. This study assesses the superadded value of MRI in diagnosing causes of pathologic nipple discharge. Ninety-three patients with pathologic nipple discharge were evaluated by sonomammography and DCE-MRI. Sonomammography and MR imaging features were analyzed and correlated with the histopathology. Results: Histopathology revealed 69 benign, three high-risk, and 21 malignant lesions. Simply dilated ducts and presence of a mass on US examination as well as non-mass enhancement and STIR signal changes on MRI were of statistically significant probability in differentiation between benign and malignant causes of pathological nipple discharge (p value = 0.017 and 0.001) and (p value ≤ 0.001). Sensitivity and specificity of mammogram and ultrasound in differentiation between benign and malignant causes of pathologic nipple discharge were 71.4% and 54.2% respectively with positive predictive value of 31.2%,negative predictive value of 86.7%, and accuracy of 58.1%. MRI gave higher sensitivity and specificity of 100% and 83.3% with positive predictive value of 63.6%, negative predictive value of 100%, and accuracy of 87.1%. Conclusion: Magnetic resonance imaging is superior to sonommagraphy in diagnosis of pathologic nipple discharge and we recommend it in special situations.

show abstract

Breast imaging in patients with nipple discharge

Cited by 28 publications

References 30 publications

Second-look breast ultrasonography after galactography in patients with nipple discharge

Second-look breast ultrasonography after galactography in patients with nipple discharge

Interventional Ductoscopy as an Alternative for Major Duct Excision or Microdochectomy in Women Suffering Pathologic Nipple Discharge: A Single-center Experience

MRI for assessment of pathologic nipple discharge: is it mandatory?

Contact Info

Product

Resources

About