Jose Maria Oliver-Goldaracena, Presenter: Nothing to Disclose

Marta Onate Miranda MD, Abstract Co-Author: Nothing to Disclose

Vicenta Cordoba Chicote, Abstract Co-Author: Nothing to Disclose

Agustin Andres Mateo, Abstract Co-Author: Nothing to Disclose

Maria Jose Roca Navarro, Abstract Co-Author: Nothing to Disclose

Carlos Rubio Hervas, Abstract Co-Author: Nothing to Disclose

To review clinical and pathologic outcomes in patients with pathologic nipple discharge and US findings concordant with small benign papilloma at US-Guided Vacuum-Assisted (US-VA) removal.

At our institution patients with pathologic nipple discharge are evaluated with US. Diagnosis of benign papilloma is considered when a single benign intraductal mass (BIRADS 3) within a dilated duct is detected on US and fulfills at least one of these criteria: color-Doppler signal, correlation on ductography or FNA suggesting benign papillary lesion. Since April 2010, we have been managing those lesions of 20mm or less with US-VA removal. We performed a retrospective review of the pathology records of US-VA removal of 61 probably benign intraductal papillomas (mean size 9mm, range 3-20mm) in a consecutive series of 57 patients (mean age 64, range 24-85) between April 2010 and October 2013. Histology was reviewed by three pathologists. Follow up and histological diagnosis were recorded.

At histology, 60 lesions were intraductal papillomas (98%), 58 benign and 2 atypical ; in 1 case the diagnosis was periductal fibrosis. Nipple discharge disappeared in all but one case. All patients underwent US follow-up (mean 18 months, range 5-42) and 7 patients with benign papilloma , one of them with persistent uniorificial nipple discharge, showed residual lesions . In these cases a second US-VA removal was performed (between 2-6 months after the first US-VA removal) . In 2 of them histology showed fibrosis and in 5 benign papillomas. In these 5 patients follow-up US was normal. The 2 patients with atypical papilloma did not show residual lesions on the follow up US. Pathological nipple discharge disappeared in all patients.

Ultrasound-Guided Vacuum-Assisted removal of suspected small benign intraductal papillomas seen on US , in patients with pathologic nipple discharge allows histological confirmation of benign papilloma in most of the lesions and eliminates nipple discharge in all patients .

Percutaneous US-VA excision is appropriate for the management of patients with pathologic nipple discharge in whom ultrasound shows a probable small benign papilloma.

Oliver-Goldaracena, J, Onate Miranda, M, Cordoba Chicote, V, Andres Mateo, A, Roca Navarro, M, Rubio Hervas, C, Pathologic and Clinical Outcomes at US-Guided Vacuum-Assisted Removal of Probably Small Benign Papillomas Detected on US in Patients with Nipple Discharge.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003608.html