Purpose : to evaluate the usefulness of breast ultrasonography (US) for the evaluation of pathologic nipple discharge, compared with galactography.
Materials and Methods : 67 cases with nipple discharge were enrolled in the study, who underwent US and galactography. 44 cases were pathologically proved by either surgical excision(n=37), or US-guided core needle biopsy(n=7). The pathologically confirmed cases were intraductal papilloma(n=18), fibrocystic changes(n=18), ductectasia with chronic mastitis(n=5), DCIS(n=2), and infiltrating ductal carcinoma(n=1). Two radiologists retrospectively reviewed and compared US and galactography.
Results : The lesions were depicted at galactography in 54 cases(80.6%), at US in 54 cases(80.6%) and both examinations in 45 cases(67.2%). Four cases(6.0%) showed poor visualization of lesions at both examinations. The lesions were depicted at galatography only in 9 cases(13.4%). And the lesions were visualized at US only in 9 cases(13.4%), of which galactograms were negative(n=1), only ductal dilatations(n=2), or failure of procedure(n=6). In 45 cases which abnormalities were visualized at both examinations, the depiction of lesion extent was superior at US in 9 cases and more excellent at galactogram in 8 cases. Of 67 cases, US was superior(n=18) or equal(n=32) to galactography in 50 patients(83.3%) with respect to the evaluation of lesion itself or its extent.
Conclusion : Breast US is useful to detect the causes of pathologic nipple discharge and to determine the lesion extent exactly. Therefore, in management of the patients with pathologic nipple discharge, we suggest that galactography could be skipped if the lesion was visualized adequately at US.