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Biomed Res Int. 2015;2015:806368. doi: 10.1155/2015/806368. Epub 2015 Jan 22.

Breast MRI in patients with unilateral bloody and serous-bloody nipple discharge: a comparison with galactography.

Author information

1
Department of Radiological Sciences, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy.
2
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
3
Department of Gynecology and Obstetrics, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy.

Abstract

PURPOSE:

Assessing the role of breast MRI compared to galactography in patients with unilateral bloody or serous-bloody nipple discharge.

MATERIALS AND METHODS:

Retrospective study including 53 unilateral discharge patients who performed galactography and MRI. We evaluated the capability of both techniques in identifying pathology and distinguishing between nonmalignant and malignant lesions. Lesions BIRADS 1/2 underwent follow-up, while the histological examination after surgery has been the gold standard to assess pathology in lesions BIRADS 3/4/5. The ROC analysis was used to test diagnostic MRI and galactography ability.

RESULTS:

After surgery and follow-up, 8 patients had no disease (15%), 23 papilloma (43%), 11 papillomatosis (21%), 5 ductal cancer in situ (10%), and 6 papillary carcinoma (11%) diagnoses. Both techniques presented 100% specificity; MRI sensitivity was 98% versus 49% of galactography. Considering MRI, we found a statistical association between mass enhancement and papilloma (P < 0.001; AUC 0.957; CI 0.888-1.025), ductal enhancement and papillomatosis (P < 0.001; AUC 0.790; CI 0.623-0.958), segmental enhancement and ductal cancer in situ (P = 0.007; AUC 0.750; CI 0.429-1.071), and linear enhancement and papillary cancer (P = 0.011).

CONCLUSIONS:

MRI is a valid tool to detect ductal pathologies in patients with suspicious bloody or serous-bloody discharge showing higher sensitivity and specificity compared to galactography.

PMID:
25685810
PMCID:
PMC4317598
DOI:
10.1155/2015/806368
[Indexed for MEDLINE]
Free PMC Article

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