Jung Min Chang MD, Presenter: Nothing to Disclose

Nariya Cho MD, Abstract Co-Author: Nothing to Disclose

Woo-Kyoung Moon, Abstract Co-Author: Nothing to Disclose

Jeong Seon Park MD, Abstract Co-Author: Nothing to Disclose

To evaluate whether the complete removal of a benign intraductal mass using a US-guided vacuum-assisted device can eliminate the symptom of nipple discharge

Between March 2004 and October 2006, 50 patients (median age 45, range 18-80 years) with pathologic nipple discharge and a single intraductal mass detected on US underwent US-guided, vacuum-assisted removal. A target lesion was determined when a mass was seen within a dilated duct traced to the discharging nipple duct. The median lesion size at US was 8mm (range 5-25mm). Protocol for this study included informed consent, local anesthesia, and removal of US evidence of the mass. Ten patients were excluded from this study due to loss of follow-up (n = 4), or subsequent surgery due to malignancy (n=2) or atypia (n = 4). The remaining 40 patients constituted our study population. Histologic results, medical records, and US images were reviewed to track the clinical outcome.

At biopsy histology, 70% (28 of 40) of the lesions were intraductal papilloma, 25% (10 of 40) were fibrocystic change, and 4% (2 of 40) were fibroadenoma. The discharge disappeared in 73% (29 of 40) and decreased in 10% (4 of 40) of the patients at a median follow-up of 8 months (range 4-26 month). Subsequent surgical excision was performed in 7 (17%) patients at a median period of 5 months (range 1-21 months) due to persistent nipple discharge. Lesions larger than 15 mm [75% (3 of 4) vs. 11% (4 of 36), P=.001] or lesions with nonspecific benign results [40% (4 of 10) vs. 10% (3 of 30), P=.031] more frequently underwent subsequent surgery.

US-guided vacuum-assisted removal of an intraductal mass eliminated the nipple discharge in 73% (29 of 40) of patients with benign histologic results.

US-guided, vacuum-assisted removal can be considered as an alternative to surgery when an intraductal mass less than 15 mm is seen in patients with nipple discharge, although long term follow-up is required.

Chang, J, Cho, N, Moon, W, Park, J, Ultrasound (US)-guided, Vacuum-assisted Removal of a Benign Intraductal Mass in Patients with Nipple Discharge.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5010148.html