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Evaluation of Suspicious Nipple Discharge by Magnetic Resonance Mammography Based on Breast Imaging Reporting and Data System Magnetic Resonance Imaging Descriptors

Tokuda, Yukiko MD; Kuriyama, Keiko MD; Nakamoto, Atsushi MD; Choi, Soomi MD; Yutani, Kenji MD; Kunitomi, Yuki MD; Haneda, Takashi MD; Kawai, Misa MD; Masuda, Norikazu MD; Takeda, Masashi MD; Nakamura, Hironobu MD

Journal of Computer Assisted Tomography: January/February 2009 - Volume 33 - Issue 1 - pp 58-62
doi: 10.1097/RCT.0b013e3181671ad2
Breast Imaging: Original Article

Purpose: To evaluate the findings of magnetic resonance mammography for suspicious nipple discharge based on breast imaging-reporting and data system magnetic resonance imaging (MRI) descriptors and establish any correlations with the histopathologic diagnoses.

Methods: Forty-seven patients with suspicious nipple discharge underwent MRI using a 1.5-T system. Images were evaluated for a signal of abnormal discharge, related abnormal enhancement according to the breast imaging-reporting and data system MRI descriptors, and the presence of clustered ring enhancement and were compared with the histopathologic diagnoses established in 39 lesions.

Results: The most common finding in patients with suspicious nipple discharge was non-masslike enhancement. Seventeen malignant and 22 benign lesions were detected. The most frequent findings in the malignant lesions were "segmental" (59%), "heterogeneous" (57%), and plateau pattern (40%). Clustered ring enhancement was found in 60% of the enhanced malignant lesions (P = 0.002). The combination of segmental distribution and clustered ring enhancement showed a significant association with malignant lesions (P = 0.004).

Conclusions: Magnetic resonance imaging provides clinically useful information in patients with suspicious nipple discharge.

From the *Department of Radiology, National Hospital Organization Osaka National Hospital; †Department of Radiology, Osaka University Graduate School of Medicine, Faculty of Medicine; and Departments of ‡Surgery, and §Pathology, National Hospital Organization Osaka National Hospital, Osaka, Japan.

Received for publication October 13, 2007; accepted January 3, 2008.

Reprints: Yukiko Tokuda, MD, Department of Radiology, National Hospital Organization, Osaka National Hospital, Osaka Prefecture, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006, Japan (e-mail: ytokuda@onh.go.jp).

Copyright © 2009 Wolters Kluwer Health, Inc. All rights reserved.