Breast Sonography in Localizing the Cause of Nipple Discharge

Rissanen, Tiina H.; Reinikainen, Heli; Apaja‐Sarkkinen, M.

doi:10.7863/jum.2007.26.8.1031

Cited by 51 publications

(55 citation statements)

References 21 publications

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“…Furthermore, a recent study [22] reports that direct magnetic resonance imaging galactography may provide more diagnostic information than conventional GL in patients with PND, because it can show both ductal morphology and the extent of disease before surgery. Also, sonography is a valuable method for localizing intraductal abnormalities, especially papillomatous lesions, in patients with nipple discharge with no other clinical or radiologic findings [23]. However, the sonographic detection of DCIS is difficult.…”

Section: Discussionmentioning

confidence: 99%

Role of Galactography in the Early Diagnosis of Breast Cancer

et al. 2013

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Background: The purpose of this study was to evaluate the usefulness of galactography (GL) in the early diagnosis of breast cancer in patients with pathologic nipple discharge (PND). Patients and Methods: We retrospectively studied all galactograms obtained in 117 women with PND, who subsequently had a biopsy. The findings detected in the galactograms of the patients in this study were assigned to different categories of the Galactogram Image Classification System (GICS): GICS 2, benign; GICS 3, probably benign; GICS 4, suspicious for malignancy; and GICS 5, highly suspicious for malignancy. Results: The galactograms were classified into GICS 2 (29 cases; 24.7%), GICS 3 (42 cases; 35.8%), GICS 4 (30 cases; 25.6%), and GICS 5 (16 cases; 13.6%). A good correlation was observed between histological diagnosis and GICS categories (p < 0.05). All cases diagnosed with carcinoma (n = 18) were classified in GICS categories 4-5: ductal carcinoma in situ in 14 cases (11.9%) and invasive carcinoma in 4 cases (3.4%). Conclusion: GL is a useful procedure in the early diagnosis of breast cancer in patients with PND.

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Section: Discussionmentioning

confidence: 99%

Role of Galactography in the Early Diagnosis of Breast Cancer

et al. 2013

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“…In these conditions ultrasound might be inferior to galactography and might therefore play a limited role for the detection of peripheral small intraductal masses without ductal dilatation. In ductectasia, however, ultrasound can demonstrate the underlying lesion and its relationship to the ductal system [49].…”

Section: Discussionmentioning

confidence: 99%

Can galactography-guided stereotactic, 11-gauge, vacuum-assisted breast biopsy of intraductal lesions serve as an alternative to surgical biopsy?

et al. 2009

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The purpose of this study was to determine the value of galactography-guided, stereotactic, vacuum-assisted breast biopsy (VABB) for the assessment of intraductal breast lesions and its potential as a therapeutic tool that could eliminate the need for surgical excision. Eighteen patients (median age 64 years, range 37-80) with nipple discharge and galactography-verified intraductal lesions underwent galactography-guided, stereotactic, 11-gauge VABB followed by surgery. Histopathology findings from VABB and subsequent surgery were compared. Underestimation and false-negative rates were assessed. After VABB, histopathology revealed invasive ductal carcinoma (IDC) in three (17%), ductal carcinoma in situ (DCIS) in six (33%), high-risk lesions in six (33%) and benign lesions in three (17%) cases. After surgical biopsy, histopathology confirmed the previously established diagnosis in 11 lesions (61%). The underestimation rate for high-risk lesions and DCIS was 50% (6/12). The false-negative rate was 7% (1/14). Histopathology examination after surgery showed that not a single lesion had been completely removed at VABB. Galactography-guided VABB is a feasible diagnostic tool. However, its value as a therapeutic procedure is limited because of the high number of underestimated and missed lesions and because of the histopathological detection of lesions' remnants in every case. Surgical excision should be the therapeutic gold standard in cases of pathological nipple discharge and galactography abnormalities.

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“…While MMG is considered the standard initial imaging examination and may reveal microcalcifications and other signs of malignancy, it rarely provides information about the etiology of ND (Rissanen et al, 2007citing Cabioglu et al, 2003Dillon et al, 2006;Funovics et al, 2003;Sardanelli et al, 1997;Tabar et al, 1983). In the study by Tabar et al (1983), only half of the patients who presented with ND and were diagnosed with breast cancer had an abnormal mammogram.…”

Section: Mammography (Mmg)mentioning

confidence: 96%

“…Berg & Gilbreath (2000) reported that US identified 45 of 48 (94%) invasive tumor foci and 7 of 16 (44%) foci of DCIS while only 9 of 64 (14%) malignant foci were detected by US. Rissanen et al (2007) reported that in 52 patients with unilateral nipple discharge, 80% of papillomatous lesions, 58% of other benign lesions, and 20% of malignant lesions were sonographically positive, and among the 6 cases in which duct dilatation was the only sonographic finding, 3 (50%) were malignant lesions and the other 3 (50%) were papillomas and other benign lesions. In a study of 55 patients with bloody ND, Nakahara et al (2003) reported that of all findings, only the hypoechoic masses with smooth margins (NPV = 90.9%) and hypoechoic masses with irregular margins (positive predictive value (PPV) = 85.7%) were statistically significant.…”

Section: Ultrasonography (Us)mentioning

confidence: 99%