Cargando…

The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography

OBJECTIVE: The optimal imaging approach for evaluating pathological nipple discharge remains unclear. We investigated the value of adding ductography to ultrasound (US) for evaluating pathologic nipple discharge in patients with negative mammography findings. MATERIALS AND METHODS: From July 2003 to...

Descripción completa

Detalles Bibliográficos
Autores principales: Choi, Younjung, Kim, Sun Mi, Jang, Mijung, Yun, Bo La, Kang, Eunyoung, Kim, Eun-Kyu, Park, So Yeon, Kim, Bohyoung, Cho, Nariya, Moon, Woo Kyung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Radiology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9434737/
https://www.ncbi.nlm.nih.gov/pubmed/36047541
http://dx.doi.org/10.3348/kjr.2021.0850
_version_ 1784780945111384064
author Choi, Younjung
Kim, Sun Mi
Jang, Mijung
Yun, Bo La
Kang, Eunyoung
Kim, Eun-Kyu
Park, So Yeon
Kim, Bohyoung
Cho, Nariya
Moon, Woo Kyung
author_facet Choi, Younjung
Kim, Sun Mi
Jang, Mijung
Yun, Bo La
Kang, Eunyoung
Kim, Eun-Kyu
Park, So Yeon
Kim, Bohyoung
Cho, Nariya
Moon, Woo Kyung
author_sort Choi, Younjung
collection PubMed
description OBJECTIVE: The optimal imaging approach for evaluating pathological nipple discharge remains unclear. We investigated the value of adding ductography to ultrasound (US) for evaluating pathologic nipple discharge in patients with negative mammography findings. MATERIALS AND METHODS: From July 2003 to December 2018, 101 women (mean age, 46.3 ± 12.2 years; range, 23–75 years) with pathologic nipple discharge were evaluated using pre-ductography (initial) US, ductography, and post-ductography US. The imaging findings were reviewed retrospectively. The standard reference was surgery (70 patients) or > 2 years of follow-up with US (31 patients). The diagnostic performances of initial US, ductography, and post-ductography US for detecting malignancy were compared using the McNemar’s test or a generalized estimating equation. RESULTS: In total, 47 papillomas, 30 other benign lesions, seven high-risk lesions, and 17 malignant lesions were identified as underlying causes of pathologic nipple discharge. Only eight of the 17 malignancies were detected on the initial US, while the remaining nine malignancies were detected by ductography. Among the nine malignancies detected by ductography, eight were detected on post-ductography US and could be localized for US-guided intervention. The sensitivities of ductography (94.1% [16/17]) and post-ductography US (94.1% [16/17]) were significantly higher than those of initial US (47.1% [8/17]; p = 0.027 and 0.013, respectively). The negative predictive value of post-ductography US (96.9% [31/32]) was significantly higher than that of the initial US (83.3% [45/54]; p = 0.006). Specificity was significantly higher for initial US than for ductography and post-ductography US (p = 0.001 for all). CONCLUSION: The combined use of ductography and US has a high sensitivity for detecting malignancy in patients with pathologic nipple discharge and negative mammography. Ductography findings enable lesion localization on second-look post-ductography US, thus facilitating the selection of optimal treatment plans.
format Online
Article
Text
id pubmed-9434737
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher The Korean Society of Radiology
record_format MEDLINE/PubMed
spelling pubmed-94347372022-09-07 The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography Choi, Younjung Kim, Sun Mi Jang, Mijung Yun, Bo La Kang, Eunyoung Kim, Eun-Kyu Park, So Yeon Kim, Bohyoung Cho, Nariya Moon, Woo Kyung Korean J Radiol Breast Imaging OBJECTIVE: The optimal imaging approach for evaluating pathological nipple discharge remains unclear. We investigated the value of adding ductography to ultrasound (US) for evaluating pathologic nipple discharge in patients with negative mammography findings. MATERIALS AND METHODS: From July 2003 to December 2018, 101 women (mean age, 46.3 ± 12.2 years; range, 23–75 years) with pathologic nipple discharge were evaluated using pre-ductography (initial) US, ductography, and post-ductography US. The imaging findings were reviewed retrospectively. The standard reference was surgery (70 patients) or > 2 years of follow-up with US (31 patients). The diagnostic performances of initial US, ductography, and post-ductography US for detecting malignancy were compared using the McNemar’s test or a generalized estimating equation. RESULTS: In total, 47 papillomas, 30 other benign lesions, seven high-risk lesions, and 17 malignant lesions were identified as underlying causes of pathologic nipple discharge. Only eight of the 17 malignancies were detected on the initial US, while the remaining nine malignancies were detected by ductography. Among the nine malignancies detected by ductography, eight were detected on post-ductography US and could be localized for US-guided intervention. The sensitivities of ductography (94.1% [16/17]) and post-ductography US (94.1% [16/17]) were significantly higher than those of initial US (47.1% [8/17]; p = 0.027 and 0.013, respectively). The negative predictive value of post-ductography US (96.9% [31/32]) was significantly higher than that of the initial US (83.3% [45/54]; p = 0.006). Specificity was significantly higher for initial US than for ductography and post-ductography US (p = 0.001 for all). CONCLUSION: The combined use of ductography and US has a high sensitivity for detecting malignancy in patients with pathologic nipple discharge and negative mammography. Ductography findings enable lesion localization on second-look post-ductography US, thus facilitating the selection of optimal treatment plans. The Korean Society of Radiology 2022-09 2022-08-18 /pmc/articles/PMC9434737/ /pubmed/36047541 http://dx.doi.org/10.3348/kjr.2021.0850 Text en Copyright © 2022 The Korean Society of Radiology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Breast Imaging
Choi, Younjung
Kim, Sun Mi
Jang, Mijung
Yun, Bo La
Kang, Eunyoung
Kim, Eun-Kyu
Park, So Yeon
Kim, Bohyoung
Cho, Nariya
Moon, Woo Kyung
The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography
title The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography
title_full The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography
title_fullStr The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography
title_full_unstemmed The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography
title_short The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography
title_sort value of adding ductography to ultrasonography for the evaluation of pathologic nipple discharge in women with negative mammography
topic Breast Imaging
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9434737/
https://www.ncbi.nlm.nih.gov/pubmed/36047541
http://dx.doi.org/10.3348/kjr.2021.0850
work_keys_str_mv AT choiyounjung thevalueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT kimsunmi thevalueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT jangmijung thevalueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT yunbola thevalueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT kangeunyoung thevalueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT kimeunkyu thevalueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT parksoyeon thevalueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT kimbohyoung thevalueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT chonariya thevalueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT moonwookyung thevalueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT choiyounjung valueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT kimsunmi valueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT jangmijung valueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT yunbola valueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT kangeunyoung valueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT kimeunkyu valueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT parksoyeon valueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT kimbohyoung valueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT chonariya valueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography
AT moonwookyung valueofaddingductographytoultrasonographyfortheevaluationofpathologicnippledischargeinwomenwithnegativemammography