Nipple discharge: Current clinical and imaging evaluation

Dipti Gupta*, Ellen B. Mendelson, Ingolf Karst

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

OBJECTIVE. Nipple discharge is a common complaint that is first evaluated with clinical assessment. Physiologic discharge does not require imaging other than routine screening mammography. Initial evaluation of pathologic nipple discharge involves mammography and ultrasound. evaluation of pathologic nipple discharge involves mammography and ultrasound. Because of its high sensitivity in detecting breast malignancy and its biopsy capability, MRI is increasingly used in lieu of ductography. CONCLUSION. The problem-solving algorithm for evaluating suspicious nipple discharge is evolving. When diagnostic imaging for evaluation of pathologic nipple discharge is negative, management is based on clinical suspicion. If additional imaging is warranted, MRI is preferred because of its increased sensitivity, specificity, and patient comfort. Although central duct excision is the current standard for evaluation of malignancy in patients with pathologic nipple discharge, studies suggest that, given the high negative predictive value of MRI, surveillance may be a reasonable alternative to surgery.

Original languageEnglish (US)
Pages (from-to)330-339
Number of pages10
JournalAmerican Journal of Roentgenology
Volume216
Issue number2
DOIs
StatePublished - Feb 2021

Keywords

  • Central duct excision
  • Ductography
  • Nipple discharge
  • Pathologic discharge
  • Physiologic discharge

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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