Ultrasound-guided wire localization of focal ductal dilatation in the evaluation and treatment of pathologic nipple discharge

Breast J. 2018 May;24(3):356-359. doi: 10.1111/tbj.12936. Epub 2017 Oct 24.

Abstract

Patients presenting with pathologic nipple discharge (PND) often pose a diagnostic and therapeutic challenge. We used ultrasound to identify focal ductal dilatation-hypothesized to be a radiographic manifestation of the causative lesion-in patients with PND and no relevant clinical or radiographic findings. Twenty-two excisions guided by ultrasound wire localization of focal duct dilation were performed. Surgical pathology revealed papilloma in 20 cases (91%); atypia or carcinoma was detected in 7 cases (32%). The ultrasound finding of focal duct dilatation enables excision of otherwise occult though clinically significant lesions and is worthy of further study.

Keywords: breast cancer; breast ultrasound; focal ductal dilatation; papilloma; pathologic nipple discharge.

MeSH terms

  • Adult
  • Aged
  • Breast Diseases / diagnostic imaging*
  • Breast Diseases / pathology
  • Breast Diseases / surgery*
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Carcinoma, Intraductal, Noninfiltrating / surgery
  • Female
  • Humans
  • Middle Aged
  • Nipples / diagnostic imaging*
  • Nipples / pathology*
  • Nipples / surgery
  • Papilloma / diagnostic imaging
  • Papilloma / pathology
  • Papilloma / surgery
  • Retrospective Studies
  • Ultrasonography, Mammary / methods*