The value of clinical characteristics and breast-imaging studies in predicting a histopathologic diagnosis of cancer or high-risk lesion in patients with spontaneous nipple discharge

• Published in: The American journal of surgery Vol. 190; no. 4; pp. 644 - 646
• Main Authors: Adepoju, Linda J., Chun, Jennifer, El-Tamer, Mahmoud, Ditkoff, Beth-Ann, Schnabel, Freya, Joseph, Kathie-Ann
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2005; Elsevier; Elsevier Limited
• Subjects: Adult; Age; Aged; Atypical ductal hyperplasia; Biological and medical sciences; Breast cancer; Breast Diseases - complications; Breast Diseases - diagnosis; Breast Neoplasms - complications; Breast Neoplasms - diagnosis; Breast-imaging studies; Breastfeeding & lactation; Duct excision; Female; General aspects; Gynecology. Andrology. Obstetrics; Histopathology; Humans; Lobular neoplasia; Mammary gland diseases; Mammary Glands, Human; Mammography; Medical diagnosis; Medical sciences; Middle Aged; Nipple discharge; Nipples - secretion; Predictive Value of Tests; Retrospective Studies; Sensitivity and Specificity; Tumors; Ultrasonic imaging; Ultrasonography, Mammary; Lobular neoplasia; Duct excision; Breast cancer; Atypical ductal hyperplasia; Breast-imaging studies; Nipple discharge; High risk; Hyperplasia; Spontaneous; Histopathology; Surgery; Imaging; Diagnosis; Mammary gland; Human; Excision; Patient; Malignant tumor; Medicine; Mammary gland diseases; Symptomatology; Anatomic pathology; Treatment; Breast; Medical imagery; Atypical; Lesion
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2005.06.032

The purpose of this study was to determine the utility of breast-imaging studies in identifying cancer and high-risk lesions among patients with spontaneous, single-duct, nipple discharge (SSND). The medical records of 168 cases with SSND treated with duct excision between June 1998 and May 2004 were reviewed. The sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of mammogram, ultrasound, and ductogram in predicting high-risk lesions and cancer were calculated. The sensitivity of mammography was 10%, the specificity 94%, the NPV 88%, and the PPV 18%. Ultrasongraphy had a sensitivity of 36%, specificity of 68%, PPV of 14%, and NPV of 89%. Ductography had a sensitivity of 75%, specificity of 49%, and NPV and PPV of 93% and 18%, respectively. Conventional imaging studies do not accurately identify cancer or high-risk lesions in patients with SSND.All patients with SSND should be offered duct excision.