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Eur J Radiol 2022 Jun 4;154:110394. Epub 2022 Jun 4.

School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Wuxing Street, Taipei 110, Taiwan.

Purpose: As we have previously demonstrated, breast cancers originating in the major lactiferous ducts and propagating through the process of neoductgenesis are a distinct subtype of invasive breast cancers, although by current practice they are placed within the group termed ductal carcinoma in situ (DCIS) and are consequently underdiagnosed and undertreated. Imaging biomarkers provide a reliable indication of the site of origin of this breast cancer subtype (Ductal Adenocarcinoma of the breast, DAB) and have excellent concordance with long-term patient outcome. In the present paper, the imaging biomarkers of DAB are described in detail to encourage and facilitate its recognition as a distinct, invasive breast cancer subtype. Read More

Clin Obstet Gynecol 2022 Jun 17. Epub 2022 Jun 17.

Methodist Dallas Cancer Center, Dallas, Texas.

Breast disorders arise from a myriad of etiologies. They are frequent reasons for patient encounters in primary care and obstetric and gynecologic practices. The most common complaints include breast pain, nipple discharge and breast lumps or masses. Read More

Best Pract Res Clin Obstet Gynaecol 2022 Apr 4. Epub 2022 Apr 4.

University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA. Electronic address:

Benign breast disease including palpable breast mass, mastalgia, skin changes, and nipple discharge are common gynecologic symptoms. Practitioners should be well versed in the components of clinical breast care. Workup begins with taking a thorough medical and family history to assess risk and performing a clinical breast examination. Read More

Eur J Breast Health 2022 Apr 1;18(2):172-181. Epub 2022 Apr 1.

Department of Pathology, Tekirdağ Namık Kemal University School of Medicine, Tekirdağ, Turkey.

Objective: We aimed to investigate mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI) findings of papillary breast carcinoma subtypes and to compare the diagnostic features and performance of the imaging method in distinguishing subtypes.

Materials And Methods: Forty-two patients presenting with pathological diagnosis of 45 papillary carcinoma lesions, between 2014 and 2019, were included. Cases were assigned to five subgroups according to the latest World Health Organization (WHO) classification. Read More

Curr Med Imaging 2022 Apr 15. Epub 2022 Apr 15.

Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Magnetic Resonance Imaging (MRI) is the most sensitive and advanced imaging technique in diagnosing breast cancer and is essential in improving cancer detection, lesion characterization, and determining therapy response. In addition to the dynamic contrast-enhanced (DCE) technique, functional techniques such as magnetic resonance spectroscopy (MRS), diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), and intravoxel incoherent motion (IVIM) further characterise and differentiate benign and malignant lesions thus, improving diagnostic accuracy. There is now an increasing clinical usage of MRI breast, including screening in high risk and supplementary screening tool in average-risk patients. Read More

Radiol Case Rep 2022 Apr 3;17(4):1099-1103. Epub 2022 Feb 3.

University of Virginia Medical Center, 1215 Lee Street, Charlottesville, VA 22903, USA.

Nipple discharge is a common complaint among adult women and is often evaluated by galactography. Contrast-enhanced mammography (CEM) is an emerging breast imaging modality that is useful in the evaluation of patients with nipple discharge who have a negative galactogram, especially if they are not good candidates for contrast-enhanced MRI. Here we present a case of a 37-year-old female who was 22 weeks pregnant and presented with suspicious nipple discharge. Read More

Cancer Rep (Hoboken) 2022 Feb 10:e1602. Epub 2022 Feb 10.

Clinical Department of Diagnostic and Interventional Radiology, University Hospital Centre Zagreb, Zagreb, Croatia.

Background: Nipple discharge is one of the most common symptoms related to the breast, but it is a presenting feature of breast cancer in 5%-12% of women.

Aims: The purpose of this study was to determine the diagnostic performance of digital breast tomosynthesis (DBT) in the evaluation of patients with nipple discharge and to compare it with mammography (MMG), ultrasound (US), and magnetic resonance imaging (MRI).

Methods And Results: This retrospective study included 53 patients with nipple discharge. Read More

Diagnostics (Basel) 2021 Nov 7;11(11). Epub 2021 Nov 7.

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

Objectives: To compare the application value of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) in breast galactography.

Materials And Methods: A total of 128 patients with pathological nipple discharge (PND) were selected to undergo galactography. DBT and FFDM were performed for each patient after injecting the contrast agent; the radiation dose of DBT and FFDM was calculated, and the image quality was evaluated in consensus by two senior breast radiologists. Read More

Surg Case Rep 2021 Sep 8;7(1):203. Epub 2021 Sep 8.

Department of Digestive, Breast and Thyroid Surgery, Kagoshima University Hospital, Kagoshima-shi, Japan.

Background: Although a few cases of accessory breast cancer (ABC) have been reported, most were in the axillary region. We encountered an extremely rare case of ABC in the inframammary region (IMR).

Case Presentation: The patient was a 68-year-old postmenopausal woman who had noticed a congenital accessory nipple in her left IMR with slight, occasional discharge 20 years ago. Read More

Radiol Case Rep 2021 Nov 28;16(11):3346-3349. Epub 2021 Aug 28.

Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang, Gyeonggi-do 10380, Republic of Korea.

Bloody nipple discharge in pediatric patients is rare and mostly associated with benign conditions.Despite the generally benign nature, a thorough investigation of the cause and treatment is required if a palpable lesion is present. Here, the author reports a case of bloody nipple discharge in an adolescent girl with no significant medical history. Read More

Cancer Epidemiol Biomarkers Prev 2021 03;30(3):429-431

Division of Cancer Prevention, NCI, Rockville, Maryland.

Intraductal assessment of the breast holds the potential to provide useful information regarding breast cancer risk assessment, early diagnosis, and/or response to therapy. Intraductal assessment can be through imaging (ductography), direct visualization (mammary ductoscopy), or evaluation of the intraductal fluid collected. The most common nonradiologic approaches to intraductal assessment that provide intraductal fluid for evaluation include breast nipple aspiration fluid (NAF), spontaneous nipple discharge (SND), mammary ductoscopy, and ductal lavage. Read More

Br J Radiol 2021 Apr 5;94(1120):20201013. Epub 2021 Feb 5.

New York University, Grossman School of Medicine, New York, NY, USA.

Pathologic nipple discharge (PND) is typically unilateral, spontaneous, involves a single duct, and is serous or bloody in appearance. In patients with PND, breast MRI can be helpful as an additional diagnostic tool when conventional imaging with mammogram and ultrasound are negative. MRI is able to detect the etiology of nipple discharge in 56-61% of cases when initial imaging with mammogram and ultrasound are negative. Read More

J Family Community Med 2020 Sep-Dec;27(3):216-218. Epub 2020 Sep 25.

Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Male breast cancer is itself a very rare condition and represents 0.5%-1% of all breast cancers diagnosed. Atypical ductal hyperplasia (ADH), intraductal papilloma (IP), and ductal carcinoma are also very rare in a male breast. Read More

AJR Am J Roentgenol 2021 02 9;216(2):330-339. Epub 2020 Dec 9.

Lynn Sage Comprehensive Breast Center, Prentice Hospital, Northwestern Medicine, 250 E Superior St, Chicago, IL 60611.

Nipple discharge is a common complaint that is first evaluated with clinical assessment. Physiologic discharge does not require imaging other than routine screening mammography. Initial evaluation of pathologic nipple discharge involves mammography and ultrasound. Read More

Cureus 2020 Sep 23;12(9):e10612. Epub 2020 Sep 23.

Radiology, University of Texas Medical Branch, Galveston, USA.

Breast complaints in the emergency department (ED) include trauma, infection, pain, masses, and nipple discharge. Breast cancer mimics other inflammatory conditions such as mastitis and abscess. Differentiating infectious processes versus cancer can become problematic when no imaging is used. Read More

J Med Case Rep 2020 Sep 24;14(1):164. Epub 2020 Sep 24.

Division of Surgical Oncology, University of New Mexico, Albuquerque, NM, USA.

Background: Rates of nipple-sparing mastectomies have increased over the past decade. In 2017, acellular dermal matrix was used in 56% of breast reconstructive procedures, with complication rates similar to operations without AlloDerm. Although persistent nipple discharge after nipple-sparing mastectomy is a rare event, it has been described in the literature. Read More

FP Essent 2020 Sep;496:16-20

University of Maryland School of Medicine - Department of Surgery, 655 W. Baltimore St, Baltimore, MD 21201.

Benign breast conditions are heterogenous, with varying clinical presentations. These conditions commonly include nipple discharge, breast pain, palpable masses, common breast lesions, and high-risk breast lesions. Signs and symptoms of these conditions range from pain and abnormal physical examination findings to asymptomatic abnormalities detected on breast imaging. Read More

AJR Am J Roentgenol 2021 06 5;216(6):1462-1475. Epub 2020 Aug 5.

Department of Radiology, University of Cincinnati Medical Center, 234 Goodman St, PO Box 670761, Cincinnati, OH 45267-0761.

During pregnancy and lactation, the breast undergoes unique changes that manifest as varied clinical and imaging findings. Understanding the expected physiologic changes of the breast as well as recognizing the best imaging modalities for a given clinical scenario can help the radiologist identify the abnormalities arising during this time. Discussion with the patient about the safety of breast imaging can reassure patients and improve management. Read More

Clin Breast Cancer 2020 12 8;20(6):e723-e748. Epub 2020 Jun 8.

Department of Surgical Oncology, Cancer Centre, University Medical Centre Utrecht, Utrecht, the Netherlands.

Pathologic nipple discharge (PND) is one of the most common breast-related complaints for referral because of its supposed association with breast cancer. The aim of this network meta-analysis (NMA) was to compare the diagnostic efficacy of ultrasound, mammogram, cytology, magnetic resonance imaging (MRI), and ductoscopy in patients with PND, as well as to determine the best diagnostic strategy to assess the risk of malignancy as cause for PND. Cochrane Library, PubMed, and Embase were searched to collect relevant literature from the inception of each of the diagnostic methods until January 27, 2020. Read More

Medicine (Baltimore) 2020 Jul;99(27):e21063

Department of Interventional Radiology, First Affiliated Hospital of Jiamusi University, Jiamusi, China.

Background: Overflow breast disease (OBD), also known as breast nipple discharge, refers fluid or liquid that comes out of nipple. Many patients with breast cancer experience such condition. However, it is not easy to detect it at early stage, especially for pathological OBD. Read More

Br J Radiol 2020 May 28;93(1109):20191039. Epub 2020 Feb 28.

Department of Radiology, Mayo Clinic, Rochester, Minnesota.

Objective: The purpose of this study is to assess the outcomes of symptomatic and asymptomatic solitary dilated ducts detected on mammography, ultrasound, and MRI.

Methods: All cases of isolated solitary dilated ducts between January 1, 2009 and December 31, 2016 in non-lactating females were reviewed. Clinical data, including patient's age, breast cancer history, and pathology results were collected. Read More

Breast Cancer 2020 Jul 1;27(4):607-612. Epub 2020 Feb 1.

Division of Breast Surgery, Department of Surgery, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.

Background: Microdochectomy is the gold-standard for definitive diagnosis for pathological nipple discharge (PND); however, problem of over-treating exists since majority of PND are self-limiting and due to benign causes. Ductoscopy may assist diagnosis, and triage patients for intervention or expectant management. This study aimed to evaluate if ductoscopy could reduce unnecessary microdochectomy but not compromising the diagnosis of malignancy. Read More

Eur J Radiol 2020 Jan 20;122:108754. Epub 2019 Nov 20.

Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.

Purpose: To evaluate magnetic resonance imaging (MRI) features including tumor-nipple enhancement for predicting nipple-areolar-complex (NAC) involvement in breast cancer.

Methods: A total of 249 breast cancer cases with available preoperative MRI data were studied. On MRI, tumor-nipple enhancement was evaluated 2 min (early) and 6 min (delayed) after contrast injection. Read More

Ir J Med Sci 2020 May 21;189(2):451-460. Epub 2019 Oct 21.

Department of General Surgery, University of Health Sciences, Kartal Dr. Lutfi Kirdar Training and Research Hospital, 34890, Istanbul, Turkey.

Background: The most common cause of pathological nipple discharge (PND) is single papilloma, which is a benign intraductal lesion (BIL). However, underlying malign (MIL) or high-risk intraductal lesions (HIL) should be considered during examination.

Aim: To reveal the value of conventional imaging methods (CIM), discharge characteristics, and cytology in lack of intraductal imaging methods to detect intraductal lesions (IL) and MIL that cause PND. Read More

Breast J 2020 02 11;26(2):139-143. Epub 2019 Sep 11.

Department of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.

Nipple discharge is the third breast complaint after pain and lumps. The modern high-resolution ultrasound techniques are becoming more sensitive for the visualization of intraductal changes especially focal ductal dilatation (FDD), hypothesized as a radiographic manifestation of the lesion itself and that ultrasound-guided wire localization of this finding would enable identification and excision of the causative lesion. The aim of this study was to evaluate the safety, feasibility, efficiency and outcome of ultrasound-guided wire localization of FDD as possible cause of pathological nipple discharge (PND). Read More

Breast Cancer Res Treat 2019 Nov 27;178(1):115-120. Epub 2019 Jul 27.

Breast Unit, Charring Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Rd, Hammersmith, London, W6 8RF, UK.

Introduction: The aim of this study was to determine the ability of MRI to identify and assess the extent of disease in patients with pathological nipple discharge (PND) with an occult malignancy not evident on standard pre-operative evaluation with mammography and ultrasound.

Methods: Patients presenting to the breast unit of Imperial College Healthcare NHS Trust between December 2009 and December 2018 with PND and normal imaging were enrolled in the study. Pre-operative bilateral breast MRI was performed in all patients as part of our protocol and all patients were offered diagnostic microdochectomy. Read More

Breast J 2019 07 13;25(4):654-662. Epub 2019 May 13.

Department of Diagnostic Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.

Objective: To determine the utility of ductography in conjunction with mammography and ultrasound in patients with pathologic nipple discharge, and the incremental role of MRI after triple-modality evaluation.

Materials And Methods: We retrospectively reviewed the medical records of patients who had presented with pathologic nipple discharge and had undergone mammography and/or ultrasound and ductography between January 1, 2005, and October 31, 2010. We tested the diagnostic sensitivity, specificity and accuracy of combined triple-modality evaluation as well as of MRI performed in addition to these imaging techniques. Read More

Am Fam Physician 2019 04;99(8):505-514

Thomas Jefferson University, Philadelphia, PA, USA.

Palpable breast masses, mastalgia, and nipple discharge are commonly encountered symptoms in outpatient practice, causing significant patient anxiety and precipitating medical consultation. The initial workup includes a detailed clinical history and physical examination. Women presenting with a breast mass will require imaging and further assessment to exclude cancer. Read More

Breast Cancer Res Treat 2019 Apr 3;174(3):703-709. Epub 2019 Jan 3.

University of British Columbia, Vancouver, Canada.

Purpose: Patients with spontaneous nipple discharge (SND) who have neither clinically palpable masses nor evidence of disease on imaging with mammogram and/or ultrasound are traditionally investigated with galactogram and duct excision. As breast imaging improves, it has raised the question whether galactography and microductectomy are necessary to diagnose breast cancer. The purpose of this study was to determine the incidence of malignancy in patients presenting with SND who underwent microductectomy and to evaluate the utility of duct excision and galactography in patients whose initial clinical and radiological evaluation were negative. Read More

Cancer Rep (Hoboken) 2018 12 24;1(4):e1136. Epub 2018 Sep 24.

Radiology Department, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.

Background: With the increasing use of image-guided biopsy, more breast intraductal papillomas are found than ever. Most intraductal papillomas are small, ranging from several milimeters to 2 cm.

Case: We described a case of giant intraductal papilloma of breast in a 19-year-old girl with nipple bloody discharge and rapid growth. Read More