ABSTRACT

We aimed to evaluate the radiological approach in patients with pathologic nipple discharge in the light of the results of our patients with a complaint of bloody nipple discharge.

We evaluated 22 patients with bloody nipple discharge symptom between January 2014 and June 2014. Twenty-two patients underwent ultrasound, 21 patients underwent mammography and 5 patients underwent magnetic resonance imaging. Twenty-one patients were confirmed by histopathology except a case which complaints declined in study period.

The mean age 47 years (age range, 36-71 years). As a result of the biopsy with US guidance or excision, 6 of 21 patients (29%) were cancer and 15 (71%) were benign lesions. Malignant lesions were 50% (n=3) papillary carcinoma, 33% (n=2) ductal carcinoma in situ and 17% (n=1) invasive ductal carcinoma. As benign lesions, 33% (n=5) intraductal papilloma, 27% (n=4) ductal ectasia-fibrocystic changes, 27% (n=4) infection and 13% (n=2) others (atypical ductal hyperplasia, fibradenoma) were detected. Excision results of 2 patients were intraductal papilloma and 2 patients were papillary carcinoma in four that biopsy results assessed as papillary neoplasm.

The first choice imaging modalities were mammography and ultrasound in bloody nipple discharge, if not detected pathologic findings with them, magnetic resonance imaging should be done before invasive processes in patients with continuing discharge.

Keywords: Bloody nipple discharge, papilloma, ultrasonography, magnetic resonance imaging