Pathological Nipple discharge: a comparison between breast ultrasound and mammography


Background: Nipple discharge is a relatively common complaint of females in reproductive age andafter menopause.Objectives: The aim of this study was to compare the radiological findings of mammography andultrasound in women with pathological nipple discharge (PND) of different etiology.Methods: Mammography and ultrasound were done for a total of 50 patients attending the breast clinicin Oncology Teaching Hospital in Baghdad complaining from PND. Ultrasound guided fine needleaspiration was performed for all cases, and histopathology was available for eleven cases.Results: The mean age for the women included in the study was 45.3 ± 10.4 years. Ultrasound wasable to provide clues for a possible underlying cause for all PND whereas mammography was negativein 54%. Ultrasound was more sensitive in diagnosing malignant breast lesions associated with PND(85.7%) but less specific (88.3%) as compared with mammography which had (71.4%) sensitivity and(90.6%) specificity. Negative predictive value of ultrasound and mammographywere 97.4% and 95.1%respectively.Conclusion: Ultrasound is essential to complete PND workup, particularly when mammography isnormal, to rule out the possibility of neoplastic changes and to provide clues for non-neoplastic etiologythat may guide the management.