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Pathological nipple discharge: A comparative study of galactography and MRI
SHEN Xia  MO Rongguang  ZHOU Zhiqin  JIANG Guoyuan 

Cite this article as: SHEN X, MO R G, ZHOU Z Q, et al. Pathological nipple discharge: A comparative study of galactography and MRI[J]. Chin J Magn Reson Imaging, 2023, 14(6): 75-81. DOI:10.12015/issn.1674-8034.2023.06.012.


[Abstract] Objective To compare the diagnostic value of galactography (GL) and MRI in patients with pathological nipple discharge (PND) and differential for benign and malignant lesions.Materials and Methods Forty-eight breasts with nipple discharge in 45 cases were analyzed retrospectively. The discharge was bloody in 25 cases, yellow or yellowish in 10 cases, serous in 7 cases, watery in 4 cases, brown in 2 cases. GL and MRI were performed in all cases, and pathological findings were used as the gold standard. When breast cancer, ductal papilloma and atypical hyperplasia, Breast Imaging Reporting and Data System (BI-RADS) 4-5, BI-RADS 5 were selected as positive findings, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the two diagnostic techniques for PND were compared.Results There were 48 breast lesions in 45 cases. The pathological results showed that there were 7 cases of malignant lesions, all of which were unilateral, including 2 cases of invasive ductal carcinoma, 5 cases of ductal carcinoma in situ with microinvasion and 41 cases of benign lesions. GL for the accury diagnosis of PND (breast cancer, ductal papilloma, dysplasia), sensitivity, specificity, positive predictive value, negative predictive value was 97.05%, 28.57%, 76.74%, 80.00% and 77.08%; MRI were 91.17%, 50.00%, 81.57%, 70.00% and 79.16%. When BI-RADS category 4-5 was designated as a positive finding, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of GL diagnosis were 100.00%, 12.19%, 16.27%, 100.00%, 25.00%; MRI was 100.00%, 24.39%, 18.42%, 100.00%, 35.41%. When BI-RADS category 5 was designated as a positive finding, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of GL diagnosis were 42.85%, 97.56%, 75.00%, 90.90%, 89.58%; MRI was 85.71%, 95.12%, 75.00%, 97.50%, 93.75%. The χ2 test was used for the comparison of rates between populations, and the difference between the two was not statistically significant (P＞0.05). However, the sensitivity of MRI for breast cancer (85.71%) was significantly higher than that of GL (42.85%), and its accuracy was 93.75% and 89.58%.Conclusions GL and MRI have high accuracy in the diagnosis of PND, and MRI is better than GL in the evaluation of breast cancer.
[Keywords] pathological nipple discharge；breast cancer；differential diagnosis；galactography；magnetic resonance imaging

SHEN Xia   MO Rongguang   ZHOU Zhiqin   JIANG Guoyuan*  

Breast Thyroid Center, the First People's Hospital of Zunyi, Guizhou Province (the Third Affiliated Hospital of Zunyi Medical University), Zunyi 563000, China

Corresponding author: Jiang GY, E-mail: zyyyjgy@163.com

Conflicts of interest   None.

Received  2022-10-18
Accepted  2023-05-18
DOI: 10.12015/issn.1674-8034.2023.06.012
Cite this article as: SHEN X, MO R G, ZHOU Z Q, et al. Pathological nipple discharge: A comparative study of galactography and MRI[J]. Chin J Magn Reson Imaging, 2023, 14(6): 75-81. DOI:10.12015/issn.1674-8034.2023.06.012.

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