ABSTRACT
Objective To evaluate the diagnostic efficiency of fiberoptic ductoscope versus galactography for nipple discharge. Methods Literatures on comparing the diagnostic value of galactography with fiberoptic ductoseope (FDS) on the nipple discharge were searched from the Cochrane library, Evidence based medicine (EBM ),PubMed,China Vip database, and 8 studies were intaked. Then the data was analyzed by software Metadisc1.4 and Review Manager5.1. Results There are 1170 patients in the 8 studies. The pooled estimates for sensitivity of FDS and galactography was 82%, 78%, and the pooled estimates for specificity was 51%, 50%, respectively. The weighted AUC (area under curve) was 0.776, 0.705, Q*values was 0.715, 0.657, respectively. The sensitivities and specificity of the 2 methods were not significantly different. The overall diagnostic efficacy of FDS was better than that of galactography. Conclusion FDS is better than galaetography in the diagnostic value of nipple discharge.
ABSTRACT
Objective To investigate the characteristic,diagnosis and treatment of the nipple discharge.Methods The clinical data of 174 cases who were diagnosed as nipple dlscharge from January 2001 to December2006 were collected and analyzed retrospectively.Results Among those 174 cases,136 cases were confirmed histopathologieally to be intraduetal papilloma.The confirmed diagnosis rate of intraduetal papilloma by galaetograghy was 85.00%.Carcinoma-charge rate of the intraduetal papilloma was 5.17%.Conclusion Nipple discharge was the most common symptom in the intraductal papillomatesis.The galaetography was a valuable method in the diagnosis of the intraduetal papilloma.There was carcinoma-charge possibility in the intraduetal papilloma.
ABSTRACT
PURPOSE: To evaluate the value of breast MRI in analysis of papillomas of the breast. MATERIALS AND METHODS: From 1996 to 2004, 94 patients underwent surgery due to papillomas of the breast. Among them, 21 patients underwent 3D fast low angle shot (FLASH) dynamic breast MRI. Eight masses were palpable and 11 of 21 patients had nipple discharge. Two radiologists indifferently analyzed the location, size of the lesions and shape, margin of the masses, multiplicity and ductal relation. The MRI findings were categorized according to breast imaging reporting and data system (BI-RADS) lexicon. The amount and pattern of enhancement and associated findings were also evaluated according to BI-RADS. We then compared the MRI findings with galactography, mammography and breast ultrasonography (US) and examined histopathologic correlation. RESULTS: On breast MRI, the lesion size was 0.4-1.59 cm, and 18 patients showed subareolar location. On 4.25 cm (mean 1.54) dynamic enhanced images, imaging findings showed mass (n = 10), intracystic mass (n = 3), focus (n = 5), ductal enhancement (n = 2), and segmental enhancement (n = 1). In cases of the masses, the shapes of the masses were round (n = 4), lobulated (n = 3), and irregular (n = 6), and margins were circumscribed (n = 6), microlobulated (n = 5), and indistinct (n = 2). The enhancement patterns were homogeneous enhancement (n = 7), heterogeneous (n = 3) or rim enhancement (n = 3). CONCLUSION: The contrast enhanced dynamic breast MRI was highly sensitive for diagnosis of breast papillomas. MRI could play a key role in the pre-operative work-up for multiple papillomas and papillomatosis.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Breast Neoplasms/diagnosis , Magnetic Resonance Imaging/methods , Papilloma, Intraductal/diagnosis , Sensitivity and SpecificityABSTRACT
OBJECTIVE: We wanted to compare the clinical usefulness of conventional galactography and MR contrast galactography for diagnosing patients with nipple discharge. MATERIALS AND METHODS: Both conventional galactography and MR contrast galactography were performed prospectively in 16 patients. Gadopentate dimeglumine (0.1 ml) was mixed with non-ionic contrast medium (0.9 ml) to obtain a resultant volume of 1 ml and this was used for both examinations. Following conventional galactography, MR contrast galactography was performed after direct injection of contrast media into the duct. RESULTS: Conventional galactography and MR contrast galactography were concordant in 13 (81%) of 16 patients; the results were normal in five, ductal dilatation was noted in four and intraductal filling defects were noted in four. The remaining three (19%) patients demonstrated discordant findings on the two examinations. While conventional galactography revealed filling defects, the MR contrast galactography results were normal in two patients. The third patient had kinks-stricture on conventional galactography and MR contrast galactography showed ductal dilatation. This suggested there were false positive results for the three patients' conventional galactography, and all the three patients with discordant results underwent surgery and the histopathologic evaluation showed fibrocystic changes. CONCLUSION: MR contrast galactography may be used as an alternative imaging modality for making the diagnosis of pathologic nipple discharge. However, statistically supported studies with large pools of subjects for comparing the galactography and MR contrast galactography results are needed to confirm our findings.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Breast Diseases/diagnosis , Contrast Media , Exudates and Transudates , Gadolinium DTPA , Magnetic Resonance Imaging/methods , Nipples/metabolism , Prospective StudiesABSTRACT
Ductography has become the gold standard for the evaluation of patients exhibiting pathologic nipple discharges. In nine patients (age range, 29-67 years; median age, 51 years) with invasive (n=5) or intraductal (n=4) cancer, ductographic findings were recorded, then correlated with mammographic and sonographic findings. Common ductographic findings included complete ductal obstruction, multiple irregular filling defects in the nondilated peripheral ducts, ductal wall irregularities, periductal contrast extravasation, and ductal displacement. Faint microcalcifications or ill-defined masses, which were not opacified by contrast material, were often discovered adjacent to ductal abnormalities. Mammographically and sonographically occult diffusely spreading intraductal cancers often manifested as pathologic nipple discharge. In such cases, meticulous ductographic examinations and interpretations were crucial in order not to miss breast cancers.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Breast Neoplasms/diagnostic imaging , Carcinoma, Ductal, Breast/diagnostic imaging , Nipples/diagnostic imaging , Ultrasonography, MammaryABSTRACT
PURPOSE: To compare the galactographic findings of malignant and benign disease in patients with pathologic nipple discharge and to analyze the features suggesting malignancy. MATERIALS AND METHODS: In 24 patients in whom pathologic nipple discharge had occurred, the findings of preoperative galactography were correlated with those of pathology. RESULTS: Nine of the 24 cases were malignant and the other 15 were benign. Intraductal calcification occurred in five malignant cases (56%) and two (13%) which were benign. Seven malignant cases (78%) involved the segmental ducts, and in eight (89%), the peripheral ducts below the subsegmental duct were involved. Five benign cases (33%) involved the lactiferous sinus, seven (47%) the segmental duct, and two (13%) the subsegmental duct. Distal duct dilatation occurred in four benign cases (27%), while ductal stenosis was noted in six cases (67%) and ductal distortion in seven (78%). A malignant tumor appeared as a multiple (n=5, 56%) or irregular (n=5, 56%) filling defect, and a benign tumor as a single (n=12, 80%), oval (n=6, 40%) or lobular (n=4, 27%) filling defect. CONCLUSION: At galactography, a malignant tumor frequently appeared as an irregular multiple intraductal filling defect in a peripheral duct. A benign tumor, on the other hand, appeared as an oval or lobular single lesion. The presence of ductal stenosis, distortion and intraductal microcalcifications not opacified by contrast material suggest possible malignancy.
Subject(s)
Humans , Constriction, Pathologic , Dilatation , Hand , Nipples , PathologyABSTRACT
Objective To explore the value of galactography in diagnosis of nipple discharge diseases. Methods Galactographies in 101 cases with nipple discharge confirmed by operation and pathology were analyzed restrospectively. Results There were breast duct ectasia in 23 cases, breast cystic hyperplasia in 12 cases , ductal inflammation in 8 cases, intraductal papilloma in 46 cases, ductal carcinoma in 9 cases, ductal tuberculosis in 1 case and normal duct in 2 cases. Conclusion The galactography is beneficial in diagnosis of the pathogenesis of galactorrhea and is of great value in differential diagnosis between benign and malignant lesions.
ABSTRACT
Objective To observe the X-ray appearance and clinical value of galactography.Methods 600 cases of galactorrhea confirmed by pathologly underwent galactography,among them,298 cases were blood type(49.8%),150 cases were serum type(25%),106 were rinsing type(17.7%) and others were 46 cases(7.7%).Results On galactography,the ductsl were divided into 3 groups: 345 cases were foliar type(59%),127 were ramate type(26.2%),87 were trunk type(14.8%).The main radiographic characteristics of lesions were mammary ductal ectasia in 578(96.3%),ductal distortion in 561(93.5%),irregular filling defect in ducts in 349(58.2%),and ductal damage in 39(6.5%).42 cases were breast carcinomas(7%),312 were intraductal papillary tumors(52%),129 were mammary ductal ectasia(21.5%),26 were mammary ductal mastitis(4.3%),49 were proliferous disease(8.2%),25 were mammary cyst(4.2%),17 were negative anamnesis(2.8%).Conclusion Galactography is beneficial in diagnosis of the pathogenesis of galactorrhea.
ABSTRACT
Objective To improve the diagnostic rate of mammary ductal disease by galactography and mammoscopy.Methods 100 cases of the galactographic and mommoscopy materials were retrospectively analyzed.Results Tumorous diseases including intraductal papilloma,intraductal papillary carcinoma and ductal carcinoma,they accounted for 14%,intraductal papilloma and intraductal papillary carcinoma were the most in this group(12%).Non-tumorous diseases including mammary ductal ectasia with chronicmastitis,plasma cell mastitis,mammary cyst,lobular hyperplasia and cystic hyperplasia,they accounted for 71%,mammary ductal ectasia was the most in this group(42%).Conclusion The galactography and mammoscopy are very valuable in the diagnosis and differentiating diagnosis of mammary ductal diseases.
ABSTRACT
Objective To analyse the X-ray characteristics of the intraductal papilloma and to improve the diagnostic accuracy.Methods The mammographic data of 80 cases of intraductal papilloma of breast by pathology were analysed.Results 24 cases showed circular filling defect, 12 cases showed stringy filling defect,ductal blocked in 30 cases, ductal dilation in 48 cases. Conclusion Galactography is a effective method for diagnosing intraductal papilloma of the breast.
ABSTRACT
Objective To improve the mammographic diagnostic level of breast ductal diseases.Methods X-ray features,operationand pathologic findings in 166 cases of breast disease were retrospectively analyzed.Results The galactography of all 166 cases showed the manifestations including 78 cases of mammoductal ectasis with ductal dilatation,smooth wall;2 cases of ductal ectasis complicated by infection with ductal dilatation,inregular coarsening wall and interstitial extravasation of contrast medium;11 cases of mammoglandular cystic lobular hyperplasia with cyetic dilatation of terminal ducts in different sizes;49 cases of intraductal papilloma with sound as ovoid fillingdefects showing as interrupted smooth bordered,"cupping" in 26 cases of intraductal papillary carcinoma or intraductal carcinoma with post dilatation ductal stenosis and sigid "amputation" absuption together with sound cauliflower or inregular filling defects.In this series of 166 cases,75 cases vice prover to be tumor(45.1%) with malignancy in 26 cases(15.7%).Conclusion Galactography is an important method for diagnosis and differential diagrosis of mammoglandular disease with nipple discharge.
ABSTRACT
Objective To study X-ray differential diagnosis of the occupied lesions of the mammary ducts. Methods X-ray features, clinical manifestations and pathological result in 103 patients with pathologically-proved mammary ductal lesions were retrospectively analyzed.Results The mammary ductal occupied lesions in the study included intraductal papilloma (n=70), intraductal papillary carcinoma (n=15), intraductal papillomatosis (n=11), intraductal chronic mastitis (n=7).Conclusion The section, morphological features, size, number and the ductal variety of the lesions and discharge quality are of great value for the differential diagnosis of occupied lesions.
ABSTRACT
Objective To investigate the value of galactography in the diagnosis with nipple discharge.Methods 40 cases of galactography with nipple discharge proved by clinic and pathology were analyzed retrospectively.Results There were normal ducts in 7 cases, simple duct dilatation in 17 cases, breast duct dilatation accompanied chronic mastitis in 4 cases, breast duct dilatation accompanied hyperplasia in 2 cases, intraductal papilloma in 8 cases, ductal carcinoma in 1 case and abscess of the breast in 1 case.Conclusion Breast galactography plays important roles in diagnosis and differentiation of the breast disease with nipple discharge, and provides significant information for clinical department.
ABSTRACT
Objective To explore the X-ray characteristic findings of the intraductal papilloma to improve the radiologic diagnostic rate.Methods The mammographic data of 70 cases with intraductal papilloma of breast by pathology were analysed.Results Among 66 patients with nipple discharge 29 cases showed circular filling defect,7 cases showed stringy filling defect,17 cases had irregular filling defect,13 cases had mammary duct blocked ;4 cases with no nipple discharge all showed nodes.Conclusion To recognize the specific X-ray findings of intraductal papilloma of breast is valuable for diagnosis.
ABSTRACT
Objective To explore the value of galactography in the diagnosis of breast diseases with nipple discharge. Methods X-ray features, clinical manifestations and pathological results in 70 patiens with nipple discharge proved by clinic and pathology were analyzed retrospectively. Results There were intraductal papilloma in 45 cases, ductal carcinoma in 5 cases, ductal dilatation in 17 cases, breast duct hyperplasia accompanied chronic mastitis in 3 cases .Conclusion Galactography plays important role in diagnosis and differentiation of the breast duct tumor and chronic mastitis diseases, and provides significant information for clinic.