Dual-imaging assessment of ultrasonography and mammography in nipple discharge patients: A cohort study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12079-e12079
Author(s):  
Bo Li ◽  
Yihe Yang
Keyword(s):  
Breast Cancer ◽  
Clinical Judgment ◽  
Nipple Discharge ◽  
Surgical Excision ◽  
Control Group ◽  
Clinical Approach ◽  
Surgical Indications ◽  
Diagnostic Ability ◽  
Palpable Mass ◽  
Dual Imaging

e12079 Background: Nipple discharge (ND) is a common complaint of women. There is no consensus on clinical approach in these patients. We investigated the diagnostic ability of combination of ultrasound (US) and mammogram (MG) in Chinese ND patients without palpable mass. Methods: 827 patients with ND as only chief complaint presented in the First Hospital of China Medical University (Shenyang, China) between 2008 and 2015 were included. Palpable mass, physiological NP and/or elevated PRL were excluded. All patients underwent dual-imaging examinations of US and MG. Indication of surgical excision included 1) BI-RADS categories 4b, 4c, 5 in either US or MG, and/or 2) US suspected papilloma. Patients met surgical indications served as study arm (N = 742). Patients did not meet surgical indications but underwent surgery served as control arm (N = 85). Reason of surgery in the control group were patients’ choices and surgeons’ clinical judgment. Histological diagnosis provided by surgery were analyzed. In our institution, breast cancer, papilloma, and/or papilloma with atypical dysplasia were regarded as histological indication of surgery. Chi-square tests were applied. Results: Histology revealed 88 (11.9%) breast cancer in the study arm and 0 breast cancer in the control arm ( p= 0.0008); 167 (22.5%) papilloma with atypical dysplasia in the study arm and 12 (13.6%) papilloma with atypical dysplasia in the control arm ( p= 0.08); 335 (45.1%) papilloma without atypical dysplasia in the study arm and 27 (30.7%) papilloma without atypical dysplasia in the control arm ( p= 0.02). A total of 590 (79.5%) in the study arm and 39 (44.3%) in the control arm met histological indication of surgical intervention ( p< 0.00001). Conclusions: This dual-imaging assessment of US and MG is sensitive in detecting breast cancer in ND without palpable mass patients. It showed diagnostic ability in detecting papilloma with/without atypical dysplasia, but needs further improvement.

The Role of Galactography in the Detection of Breast Cancer

1988 ◽  
Vol 74 (2) ◽  
pp. 177-181 ◽  
Author(s):  
Stefano Ciatto ◽  
Patrizia Bravetti ◽  
Daniela Berni ◽  
Sandra Catarzi ◽  
Simonetta Bianchi
Keyword(s):  
Breast Cancer ◽  
Physical Examination ◽  
Benign Lesion ◽  
Nipple Discharge ◽  
Surgical Excision ◽  
Histologic Examination ◽  
Breast Cancers ◽  
Bloody Nipple Discharge ◽  
Low Incidence

The authors report on a series of 529 consecutive patients examined on physical examination, mammography, nipple discharge cytology and galactography. The criterion for galactography was essentially bloody nipple discharge (73% of cases). Serous nipple discharge was not considered worthy of routine galactography since it is associated with an extremely low incidence of breast cancer. Surgical excision and histologic examination of the discharging duct was performed in 200 cases. Eighteen cases of breast cancer were detected (10 infiltrating, 8 intraductal) of which 9, 6, 7 or 7 were suspected on physical examination, mammography, cytology or galactography, respectively. All combined tests suspected 13 of 18 breast cancers; 3 intraductal breast cancers were biopsied because of evidence of multiple papillomas on galactography, and 2 infiltrating breast cancers were operated because of persistent bloody nipple discharge in the absence of any other sign. No breast cancer was suspected on galactography alone. Galactography is indicated in the presence of bloody nipple discharge, and a biopsy should be performed when breast cancer or multiple papillomas are suspected. The diagnosis and excision of a single papilloma (breast cancer was never misdiagnosed as a single papilloma on galactography) is not worthwhile since a single papilloma is a benign lesion, and the benefit of its excision is still unclear.

scholarly journals “A Study of Clinical and Ultrasonographic Findings of Patients Presented With Breast Pain”

2021 ◽  
Vol 8 (08) ◽  
pp. 5574-5577
Author(s):  
Waliur Rahman ◽  
Shireen jabeen Sume ◽  
Shamima Yasmin
Keyword(s):  
Breast Cancer ◽  
Nipple Discharge ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Age Group ◽  
Breast Pain ◽  
Duration Of Symptoms ◽  
Palpable Mass ◽  
Palpable Lump ◽  
Study Results

Introduction: Breast pain also known as mastalgia is the dull acne in the breast, cause is multifactorial. It can affect any age group. Breast cancer is the most common site-specific cancer in women and is the leading cause of death from cancer for women aged 20-59 years worldwide. In India, breast cancer has ranked number one cancer among females, with age adjusted incidence as high as 25.8 per 100,000 women and mortality 12.7 per 100,000 women.  Objective: To find out the Clinical and USG Findings of Patients Presented with Breast Pain.   Settings and Design: Prospective cross-sectional descriptive study.   Materials and Methods: Patients with complaints of breast pain in the age group 15 to 60 years with clinically no palpable mass attending to the Dept. of General Surgery, Chuadanga Sadar Hospital, Chuadanga, Bangladesh between January 2020 to December 2020 were included in the study. Detailed history with particular reference to age, duration of symptoms, Size, menstruation, marital status, parity, lactation, Nipple discharge and tenderness are recorded. Pain intensity was evaluated as mild, moderate and severe. Ultrasound of the breast including the axilla was done for all cases and findings recorded to correlate with clinical features. Results: Out of 90 patients studied, majority was in the age group (21-30) years, (43%) followed by (31-40 years) (40%) respectively. 57(63%) were married and 33(43%) were single. 21 patients had 1 child, 18 had 2 children with 6 of them having no children. Out of 90 patients only 3 attained menopause, rest of them have their monthly cycles. 51 patients had cyclical breast pain and 39 had noncyclical breast pain, 39 had pain on right breast, 36 on left side and bilateral in 15 patients. Pain was mild in 15 patients, moderate in 27 patients and severe in 6 patients. Various USG findings of the affected breast were normal study in 48 patients followed by duct ectasia and hetrogenous ectogenicity fibroadenosis, small cystic lesion and enlarged axillary lymph nodes etc. Conclusion: The study results show that majority of patients with breast pain without clinically palpable lump had normal USG study. But it also detects other early changes in the breast tissue. It can be used as a baseline investigation for any breast pain without palpable lump.

Unilateral nipple discharge in a man without a palpable mass diagnosed as breast cancer

2020 ◽  
Vol 13 (11) ◽  
pp. e236223
Author(s):  
Karan N Ramakrishna ◽  
Justin Durland ◽  
Christopher Ramos ◽  
Amit Singh Dhamoon
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Ductal Carcinoma ◽  
Early Recognition ◽  
Nipple Discharge ◽  
Care Physician ◽  
Male Breast ◽  
Laboratory Findings ◽  
Palpable Mass ◽  
History Of

A 69-year-old man without a family history of breast cancer presented to his primary care physician with a 1-year history of clear, unilateral nipple discharge (ND) without an associated palpable breast mass. His laboratory findings were significant for hyperprolactinaemia at 28 ng/mL. Diagnostic work up including mammography, ultrasound and core needle biopsy ultimately revealed a ductal carcinoma in situ and a rare papillary variant of invasive ductal carcinoma. The patient was referred to a multidisciplinary oncology team and underwent a right total mastectomy followed by adjuvant hormonal therapy. The patient made a good postoperative recovery and remains without evidence of recurrence 6 months from surgery. Male breast cancer is rare, but its incidence is increasing. Male breast cancer presenting as ND without a palpable mass is uncommon. Early recognition of breast symptoms in men can lead to earlier diagnoses and improved outcomes.

A Clinical Analysis of 640 Inpatients With Pathologic Nipple Discharge

2021 ◽  
Author(s):  
Gang Wei ◽  
Rui Li ◽  
Gaosong Wu
Keyword(s):  
Breast Cancer ◽  
Methylene Blue ◽  
Nipple Discharge ◽  
Clinical Analysis ◽  
Surgical Indications ◽  
Double Standards ◽  
Mammary Duct ◽  
Fiberoptic Ductoscopy ◽  
Pathologic Nipple Discharge ◽  
Missed Diagnosis

Abstract Objective To discuss the value of early confirmation of breast cancer in patients with pathologic nipple discharge based on double surgical indications under fiberoptic ductoscopy (FDS) followed by staining with methylene blue. Methods From October 2012 to October 2019, a total of 640 inpatients with pathologic nipple discharge from Wuhan University Zhongnan Hospital underwent fiberoptic ductoscopy, followed by injection of methylene blue into the lesional duct through the discharged hole that would be resected as a segment according to the range of the staining duct on the next day. Based on double surgical indications, different findings by fiberoptic ductoscopy were defined as surgical indications, both with space-occupying intraductal lesions scanned by FDS and without space-occupying intraductal lesions but with dark red bloody fluid or yellow serous fluid spillage at the opening of the terminal mammary duct or extensive erosive duct lesions. We retrospectively analyzed the relations between results from fiberoptic ductoscopy and pathologic diagnosis. Results Inpatients with pathological neoplasm accounted for 87.3%(452/518) of the 518 inpatients with space-occupying intraductal lesions scanned by FDS, but the 122 inpatients without space-occupying intraductal lesions only accounted for 28.7%(35/122) of the patients (P=0.00). However, patients pathologically diagnosed with breast cancer accounted for 11.8% (61/518) of the 518 inpatients with space-occupying lesions and 10.7%(13/122) of the 122 inpatients without space-occupying lesions (P=0.728). Conclusions According to the double standards of surgical indication with or without space-occupying intraductal lesions scanned by fiberoptic ductoscopy, the method of fiberoptic ductoscopy followed by staining of the mammary duct by methylene blue could not only avoid missed diagnosis of breast cancer caused by ductoscopy itself, but also reduce the rate of missed diagnosis on account of inoperative inaccurate resection range, which greatly improved the early diagnosis rate of breast cancer with nipple discharge as the only initial clinical manifestation.

Is a one-step operation for breast cancer patients presenting nipple discharge without palpable mass feasible?

The Breast ◽  
2002 ◽  
Vol 11 (5) ◽  
pp. 402-407 ◽  
Author(s):  
Ming-Feng Hou ◽  
Kun-Bow Tsai ◽  
Fu Ou-Yang ◽  
Hsiang-Ju Lin ◽  
Chiang-Shin Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Nipple Discharge ◽  
Breast Cancer Patients ◽  
Palpable Mass ◽  
One Step

scholarly journals Smart Gold-Polymer Nanostructures As Promising Drug Nanocarriers For Dual-Imaging Modality And Synergistic Chemo-Photothermal Therapy in Breast Cancer Cells

2021 ◽  
Author(s):  
Mehdi Azizi ◽  
Asrin Pakravan ◽  
Hadi Valizadeh ◽  
Reza Rahbarghazi ◽  
Hassan Dianat-Moghadam ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Photothermal Therapy ◽  
Apoptotic Cell ◽  
Folate Receptor ◽  
Cancer Therapeutics ◽  
Ct Imaging ◽  
Host Cells ◽  
Control Group ◽  
Polymer Nanostructures ◽  
Dual Imaging

Abstract To improve the efficacy of cancer therapeutics, highly sensitive imaging with precise accuracy is mandatory for timely diagnosis and selection of strategic approaches. Despite recent advances in technologies associated with tumor imaging, the application of conventional single-mode imaging is the subject of debate. Herein, two types of pH-responsive gold-polymer nanostructures, GNSts and GNRs, containing CD and MTX, GNSts-MTX@CD-Pol and GNRs-MTX@CD-Pol were designed. Dual-imaging modalities (fluorescence and CT imaging) and synergistic chemo-photothermal therapy were examined in human breast cancer MDA-MB 231 cells. MTT assay showed NIR irradiation of cells pre-treated with synthesized nanoparticles promoted tumoricidal synergy via the reduction of survival rate after 48 hours in comparison with the control group (p<0.05), indicating a high absorption coefficient in the NIR area and efficient heat production rate. Flow cytometry, real-time PCR and western blot, analyses indicated an apoptotic cell death induced by the up-regulation of Caspases 3, 6, 7, 8, and 9, Bax, and Annexin-V, confirming the activation of intrinsic and extrinsic apoptosis pathways inside the host cells. The elevation of p27 and p53 in line with the increase of cell percent at the subG1 phase showed apoptotic changes and inhibition of dynamic cell growth compared to the non-treated cells (p<0.05). Evident fluorescence intensity at lower pH values (6.3) showed pH-dependent activity of nanoparticles internalized by surface folate receptor. Of note, we showed strong capability for CT imaging in cells incubated with GNSts-MTX@CD-Pol and GNRs-MTX@CD-Pol. Taken together, all data show that gold-polymer nanostructures have considerable capability in theranostic applications like simultaneous diagnostic imaging and therapy.

Breast cancer in male veterans: A retrospective chart review.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12531-e12531
Author(s):  
Anita Aggarwal ◽  
Min-Ling L Liu ◽  
Nihar Kiritkumar Patel ◽  
Rebecca Evangelista ◽  
Steven Krasnow
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma ◽  
Nipple Discharge ◽  
Agent Orange ◽  
Clinicopathologic Characteristics ◽  
Palpable Mass ◽  
Bloody Nipple Discharge ◽  
Male Veterans ◽  
Male Patients

e12531 Background: Male breast cancer (BCA) is rare and makes up < 1% of all of breast cancer cases. Treatment is mainly based on what is known from female BCA and survival is similar between genders. Objectives: To investigate the clinicopathologic characteristics of BCA and overall survival in male veterans. Methods: Medical records of male patients diagnosed with breast cancer at the Veterans Affairs Medical Centers of Washington DC, Baltimore and Martinsburg from 1992-2012 were reviewed after Institutional Review Board approval. Results: From 1995-2012, 51 male patients with BCA were identified from cancer registry. 29/51(57%) were African American (AA), 41% Caucasian (WM), and 2% other race. Median age was 70 years (44-86years). Palpable mass was presenting symptom in 41/51(80%) and 8(16%) had gynecomastia or bloody nipple discharge. Family history of breast cancer was positive in 11 patients without mention of BRCA genes except pt #24 who was BRCA2+. 3 patients were exposed to Agent Orange. ER/PR was positive in 36(71%), ER+/PR- in 1(2%), ER+/PR+/HER2+ in 2(4%), ER-/PR-/HER- in 2(4%). 41% & 57% had right and left BCA, respectively. 40 (80%) underwent mastectomy. 18(36%) had lymph node involvement (1-13 LN). 90% had invasive ductal carcinoma (IDC), 8% DCIS, and 2% sarcoma. Cancer in 26% was stage I, 38% stage II, 18% stage III and 8% stage IV. 12(24%) received combination chemotherapy. 33(66%) were given tamoxifen. 4(8%) patients had relapsed/recurrent disease in 1-5 years of their diagnosis and died within 2-12 years after the relapse. At median follow up of 174m (4m-19years), 28(56%) patients died (cause of death not known in all), 21(42%) alive and 3(6%) lost to follow up. Conclusions: Median age at diagnosis of BCA seems to be higher in males (70 years) as compared to historical female age (60 years). IDC is the main pathology and 73% tumors were ER +. Survival rate is approximately 40% at >10years of follow up. Survival by stage revealed no difference.

scholarly journals Male Breast Cancer Presenting as Nipple Discharge

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
A. Farooq ◽  
K. Horgan
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Early Diagnosis ◽  
Male Breast Cancer ◽  
Nipple Discharge ◽  
Male Breast ◽  
Palpable Mass ◽  
Delay In Diagnosis ◽  
Underlying Malignancy ◽  
Rare Symptom

Male breast cancer (MBC) is a rare disease and constitutes less than 1% of all breast carcinoma cases. Although MBC most often presents with a palpable mass, failure to recognise the significance of other symptoms may lead to a delay in diagnosis. Nipple discharge (ND) is a rare symptom in men, but it may herald an underlying malignancy. We present two cases of (MBC) presenting with ND and emphasise the importance of this clinical sign in suspecting underlying malignancy and an opportunity for early diagnosis. We also discuss the clinical significance of ND in men in relation to current literature.

scholarly journals Clinical and USG Findings of Patients Presented with Breast Pain

2021 ◽  
Vol 2 (2) ◽  
pp. 01-04
Author(s):  
H. N. Ashikur Rahaman ◽  
Shravana Kumar Chinnikatti
Keyword(s):  
Breast Cancer ◽  
Nipple Discharge ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Age Group ◽  
Breast Pain ◽  
Duration Of Symptoms ◽  
Palpable Mass ◽  
Palpable Lump ◽  
Study Results

Introduction: Breast pain also known as mastalgia is the dull acne in the breast, cause is multifactorial. It can affect any age group. Breast cancer is the most common site-specific cancer in women and is the leading cause of death from cancer for women aged 20-59 years worldwide. In India, breast cancer has ranked number one cancer among females, with age adjusted incidence as high as 25.8 per 100,000 women and mortality 12.7 per 100,000 women. Objective: To find out the Clinical and USG Findings of Patients Presented with Breast Pain. Settings and Design: Prospective cross-sectional descriptive study. Materials and Methods: Patients with complaints of breast pain in the age group 15 to 60 years with clinically no palpable mass attending to the Dept. of Clinical Oncology, Enam Medical College & Hospital, Savar, Dhaka, Bangladesh between January 2020 to December 2020 were included in the study. Detailed history with particular reference to age, duration of symptoms, Size, menstruation, marital status, parity, lactation, Nipple discharge and tenderness are recorded. Pain intensity was evaluated as mild, moderate and severe. Ultrasound of the breast including the axilla was done for all cases and findings recorded to correlate with clinical features. Results: Out of 90 patients studied, majority was in the age group (21-30) years, (43%) followed by (31-40 years) (40%) respectively. 57(63%) were married and 33(43%) were single. 21 patients had 1 child, 18 had 2 children with 6 of them having no children. Out of 90 patients only 3 attained menopause, rest of them have their monthly cycles. 51 patients had cyclical breast pain and 39 had noncyclical breast pain, 39 had pain on right breast, 36 on left side and bilateral in 15 patients. Pain was mild in 15 patients, moderate in 27 patients and severe in 6 patients. Various USG findings of the affected breast were normal study in 48 patients followed by duct ectasia and hetrogenous ectogenicity fibroadenosis, small cystic lesion and enlarged axillary lymph nodes etc. Conclusion: The study results show that majority of patients with breast pain without clinically palpable lump had normal USG study. But it also detects other early changes in the breast tissue. It can be used as a baseline investigation for any breast pain without palpable lump.

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