Role of breast Magnetic Resonance Imaging (MRI) in patients with unilateral nipple discharge: preliminary study

Abstract

Breast MRI can be considered a valuable examination in the diagnosis of suspected ductal disease and an alternative to galactography when the latter cannot be used.

Implications of nipple discharge in Hong Kong Chinese women

“…16 Its routine use in patients with a breast lesion is nonetheless limited by its relatively low specificity of 72% (95% confidence interval, 67%-77%). 17 The role of magnetic resonance imaging in patients with nipple discharge has been extensively validated, [18][19][20][21] suggesting that it may detect or exclude the presence of carcinoma with a high degree of certainty. Magnetic resonance imaging may be considered when all other available strategies are inconclusive.…”

Ductectasia of the Breast; An Experience With Hadfield Operation (Radical Excision of the Subareolar Duct System)

“…Although not a routine practice in the United Kingdom; a number of techniques have been used to determine the cause of nipple discharge, beyond the triple assessment. Nipple discharge cytology has a low sensitivity for the detection of breast cancer (19) and is unlikely to alter the management of patients with nipple discharge (20) . Hadfield's procedure and microdochectomy are the most common techniques for the surgical treatment of patients with nipple discharge.…”

Suspicious Nipple Discharge Diagnostic Evaluation

“…The most common sonographic features are duct dilatation, particularly in cases associated with solid internal echoes and duct wall thickening in generally central and/or subareolar areas (Ballesio et al, 2008). 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.…”

“…In addition to the patient's clinical history and cytological evaluation of the ND, performing a US-guided FNA is fundamental for differentiating between malignant and benign lesions (Ballesio et al, 2008citing Sardanelli et al, 1997.…”

“…Nakahara et al (2003) reported that segmental clumped enhancement (PPV = 100%), a focal mass with a smooth border (NPV = 91.7%), and diffuse or regional stippled enhancement (NPV = 94.1%) were statistically significant features that can be used for differentiating between malignant and benign lesions. Ballesio et al (2008) reported that 5 papillomatosis lesions appeared as patchy, homogeneously enhanced areas, that among 15 intraductal papillomas, some had an oval appearance with well-defined margins, while other had areas of homogeneous enhancement with a linear shape at the periareolar or subareolar sites, moreover, they reported 2 cases of atypical ductal hyperplasias with diffuse nodular enhancement. One micropapillary DCIS, 1 papillary carcinoma, and 1 invasive ductal carcinoma were visualized as 2 segmental areas of enhancement and 1 mass-like enhancement with poorly defined margins.…”