Balasim, B., Ahmed, S. (2023). Dynamic Contrast Enhanced Magnetic Resonance Imaging in Pathological Nipple Discharge. Alustath, 22(4), 455-463. doi: 10.52573/ipmj.2023.182296
Balsam Muzahim Balasim; Sahar Basim Ahmed. "Dynamic Contrast Enhanced Magnetic Resonance Imaging in Pathological Nipple Discharge". Alustath, 22, 4, 2023, 455-463. doi: 10.52573/ipmj.2023.182296
Balasim, B., Ahmed, S. (2023). 'Dynamic Contrast Enhanced Magnetic Resonance Imaging in Pathological Nipple Discharge', Alustath, 22(4), pp. 455-463. doi: 10.52573/ipmj.2023.182296
Balasim, B., Ahmed, S. Dynamic Contrast Enhanced Magnetic Resonance Imaging in Pathological Nipple Discharge. Alustath, 2023; 22(4): 455-463. doi: 10.52573/ipmj.2023.182296

Dynamic Contrast Enhanced Magnetic Resonance Imaging in Pathological Nipple Discharge

Iraqi Postgraduate Medical Journal
Volume 22, Issue 4, October 2023, Pages 455-463    PDF (626.57 K)
Document Type: Review Article
DOI: 10.52573/ipmj.2023.182296
Authors
Balsam Muzahim Balasim* 1; Sahar Basim Ahmed2
1Al Sheikh Zayid Hospital, Baghdad, Iraq
2Al Yarmouk Teaching Hospital, Baghdad, Iraq
Abstract
BACKGROUND:
Generally, nipple discharge represents a benign etiology. In the case where the discharge is unilateral, uniductal, spontaneous, persistent, serous or bloody, and in the case where it occurs in conjunction with a mass, the risk of malignancy is increased. Ductal ectasia and papilloma are the most common causes of pathological nipple discharges. Malignancy is a possibility, most often ductal carcinoma in situ.
OBJECTIVE:
To determine the value regarding dynamic contrast improved magnetic resonance imaging (MRI) in diagnosing suspicious nipple discharge.
METHOD AND PATIENTS:
Dynamic contrast MRI was used to assess 35 patients who have pathological nipple discharges.                    The features of MRI have been studied and associated to the histo-pathology.
RESULTS:
Histopathology indicated 11 high-risk, 17 benign, and 7 malignant lesions. The presence of non-mass and mass enhancements, as well as T2 weighted MRI images, had statistical significance in distinguishing malignant from benign causes of the pathological nipple discharges (Pvalue=0.004 and0.008) (0.018,0.008,0.004).
94.1% specificity and 94.4% sensitivity in distinguishing benign from malignant pathological nipple discharge causes, and 94.3% accuracy in diagnosing breast lesions, with positive predictive value                  of 94.4% as well as a negative predictive value of 94.1%.
CONCLUSION:
MRI is a powerful technique for determining the cause of pathological nipple discharge.
 
Keywords
Pathological; Nipple discharge; MRI
References
1.Lippa N, Hurtevent-Labrot G, Ferron S, et al. Les écoulements mamelonnaires. Journal de Radiology Diagnostique et Interventionnelle. 2015;96:434–450. [Google Scholar].

2.Chen L, Zhou WB, Zhao Y, et al. Bloody nipple discharge is a predictor of breast cancer risk: a meta-analysis. Breast Cancer Res Treat. 2012;132:9–14. [PubMed] [Google Scholar].

3.van Gelder L, Bisschops RH, Menke-Pluymers MB, et al. Magnetic resonance imaging in patients with unilateral bloody nipple discharge: useful when conventional diagnostic are negative? World J Surg. 2015;39:184–186. [PubMed] [Google Scholar].

4.Çetin K, Sıkar HE. Evaluation and management of pathological nipple discharges without using intraductal imaging methods. Ir J Med Sci. 2020 May;189(2):451-460. [PubMed].

  1. Hamwi, M. Walid, and Ryan Winters. “Mammary Duct Ectasia.” In StatPearls. Treasure Island (FL): StatPearls Publishing, 2020.
  2. Chen, Jeon-Hor, Hui Liu, Hyeon-Man Baek, Orhan Nalcioglu, and Min-Ying Su. “MR Imaging Features of Fibrocystic Change of the Breast.” Magnetic Resonance Imaging26,no.9(November,2008): 1207–14. https://doi.org/10.1016/j.mri.2008.02.004.
  3. 7. Myers, David J., and Andrew L. Walls. “Atypical Breast Hyperplasia.” In StatPearls. Treasure Island (FL): StatPearls Publishing, 2021. http:// www. ncbi. nlm. nih. gov/ books / NBK 470258/.
  4. Vaidya, Yash, Pradeep Vaidya, and Tanvi Vaidya. “Ductal Carcinoma In Situ of the Breast.” The Indian Journal of Surgery 77, no. 2 (April 2015): 141–46. https://doi.org/10.1007/s12262-013-0987-0.
  5. Alkabban, Fadi M., and Troy Ferguson. “Breast Cancer.” In StatPearls. Treasure Island(FL): StatPearlsPublishing,2020. http://www.ncbi.nlm.nih.gov/books/NBK482286/.
10.Morrogh M, Morris EA, Liberman L, et al. The predictive value of ductography and magnetic resonance imaging in the management of nipple discharge. Ann Surg Oncol. 2017;14:3369–3377. [PubMed] [Google Scholar]

11.Grainger RG, Allison DJ, Dixon AK, et al. Grainger & Allisons diagnostic radiology: a textbook of medical imaging. Edinburgh: Churchill livingstone/Elsevier; 2015.

  1. Jiang L, Li X, Sun B, Ma T, Kong X, Yang Q. Clinicopathological features of granulomatous lobular mastitis and mammary duct ectasia. Oncol Lett. 2020 Jan;19(1):840-848. [PMC free article] [PubMed]
13.Sharma U, Sah RG, Agarwal K, et al. Potential of Diffusion-Weighted Imaging in the Characterization of Malignant, Benign, and Healthy Breast Tissues and Molecular Subtypes of Breast Cancer. Frontiers in Oncology. 2016; 6.

14.M. Lorenzon, C. Zuiani, A. Linda, V. Londero, R. Girometti, M. BazzocchiMagnetic resonance imaging in patients with nipple discharge: should we recommend it?

     Eur Radiol, 2011;21:899-907 CrossRefView Record in ScopusGoogle Scholar

15.Prince JL, Links JM. Medical imaging signals and systems. Upper Saddle River, NJ: Pearson Prentice Hall; 2006.

16.Yılmaz R, Bender O, Yabul FC et al (2017) Diagnosis of nipple discharge: value of magnetic resonance imaging and ultrasonography in comparison with ductoscopy. Balkan Med J 34:119–126

17.Zaky, Mona M., Asmaa Hafez, Marwa M. Zaky, Ashraf Shoma, Nermin Y. Soliman, and Ali H. Elmokadem. “MRI for Assessment of Pathologic Nipple Discharge: Is It Mandatory?” Egyptian Journal of Radiology and Nuclear Medicine 50, no. 1 (December 17, 2019): 92. https://doi.org/10.1186/s43055-019-0105-9

18.Yang, Shih-Neng, Fang-Jing Li, Jun-Ming Chen, Geoffrey Zhang, Yen-Hsiu Liao, and Tzung-Chi Huang. “Kinetic Curve Type Assessment for Classification of Breast Lesions Using Dynamic Contrast-Enhanced MR Imaging.” PLoS ONE 11, no. 4 (April 7, 2016). https://doi.org/10.1371/journal.pone.0152827

  1. DOrsi CJ, Mendelson EB, Ikeda DM, et al. ACR breast imaging and reporting data system: breast imaging atlas. Reston, VA: American College of Radiology; 2013.
20 Breast Imaging Reporting & Data System | American College of Radiology.” Accessed April 11, 2021. https://www.acr.org/Clinical- Resources/Reporting-and-Data-Systems/Bi-Rads.

  1. Glassman L, Hazewinkel M. The Radiology Assistant: Breast - MRI [Internet]. Radiology assistant. 2009 [cited 2017Dec30].
22.Uematsu T, KasamiM.High-spatial-resolution3 Breast MRI of nonmass like enhancement lesions: An analysis of their feature sassing if I can't predictors of malignancy. AJRAmJRoentgenol 2012; 198:1223–30.

23.Kuhl C. The current status of breast MR imaging part I. Choice of technique, image interpretation, diagnostic accuracy, and transfer toclinical practice. Radiology. 2007; 244:356-78.

24.Zaky, Mona M., Asmaa Hafez, Marwa M. Zaky, Ashraf Shoma, Nermin Y. Soliman, and Ali H. Elmokadem. “MRI for Assessment of Pathologic Nipple Discharge: Is It Mandatory?” Egyptian Journal of Radiology and Nuclear Medicine 50, no. 1 (December 17, 2019): 92. https://doi.org/10.1186/s43055-019-0105-9.

  1. Paula IB, Campos AM Breast imaging in patients with nipple discharge. Radiol Bras 2017; 50:383–88.
  2. Sarica O, Ozturk E, Demirkurek HC et al Comparison of ductoscopy, galactography, and imaging modalities for the evaluation of intraductal lesions: a critical review. Breast Care 2013; 8:348–54.
27.Giovanna, Panzironi, Galati Francesca, Marzocca Flaminia, Kirchin Miles, and Pediconi Federica. “Diagnostic Accuracy of Breast MRI Compared with Conventional Imaging, in the Evaluation of Patients with Suspicious Nipple Discharge.” International Journal of Biological Instrumentation 1, no. 1 (December 31, 2018). https://doi.org/10.35840/2631-5025/5103.

  1. Bahl M, Baker JA, Greenup RA, et al. Diagnostic value of ultrasound in female patients with nipple discharge. AJR Am J Roentgenol. 2015;205:203–208. [PubMed] [Google Scholar]
  2. Manganaro, Lucia, Ilaria D’Ambrosio, Silvia Gigli, Francesca Di Pastena, Guglielmo Giraldi, Stefano Tardioli, Marialuisa Framarino, Lucio Maria Porfiri, and Laura Ballesio. “Breast MRI in Patients with Unilateral Bloody and Serous-Bloody Nipple Discharge: A Comparison with Galactography.” BioMed Research International 2015 (2015): 806368. https://doi.org/10.1155/2015/80636833.
 

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