Presenting Author:

BO LI, MBB.S.

Principal Investigator:

David Bentrem, M.D.

Department:

Surgery

Keywords:

nipple discharge, breast cancer, breast papilloma, dual-imaging assessment, ultrasonography, mammography

Location:

Ryan Family Atrium, Robert H. Lurie Medical Research Center

C131 - Clinical Women's Health Research

Dual-imaging assessment of ultrasonography and mammography in nipple discharge patients

Dual-imaging assessment of ultrasonography and mammography in nipple discharge patients: A Cohort Study Background: Nipple discharge (ND) is a common complaint of women. There is no consensus on clinical approach in these patients. We investigated the diagnostic ability of combination of ultrasound (US) and mammogram (MG) in Chinese ND patients without palpable mass. Method: 827 patients with ND as only chief complaint presented in the First Hospital of China Medical University (Shenyang, China) between 2008 and 2015 were included. Palpable mass, physiological NP and/or elevated PRL were excluded. All patients underwent dual-imaging examinations of US and MG. Indication of surgical excision included 1) BI-RADS categories 4b, 4c, 5 in either US or MG, and/or 2) US suspected papilloma. Patients met surgical indications served as study arm (N=742). Patients did not meet surgical indications but underwent surgery served as control arm (N=85). Reason of surgery in the control group were patients’ choices and surgeons’ clinical judgment. Histological diagnosis provided by surgery were analyzed. In our institution, breast cancer, papilloma, and/or papilloma with atypical dysplasia were regarded as histological indication of surgery. Chi-square tests were applied. Results: Histology revealed 88 (11.9%) breast cancer in the study arm and 0 breast cancer in the control arm (p=0.0008); 167 (22.5%) papilloma with atypical dysplasia in the study arm and 12 (13.6%) papilloma with atypical dysplasia in the control arm (p=0.08); 335 (45.1%) papilloma without atypical dysplasia in the study arm and 27 (30.7%) papilloma without atypical dysplasia in the control arm (p=0.02). A total of 590 (79.5%) in the study arm and 39 (44.3%) in the control arm met histological indication of surgical intervention (p<0.00001). Conclusion: This dual-imaging assessment of US and MG is sensitive in detecting breast cancer in ND without palpable mass patients. It showed diagnostic ability in detecting papilloma with/without atypical dysplasia, but needs further improvement.