CYduct Diagnostics Inc (CYDX)

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Breast Imaging in Nipple Discharge Evaluation
Updated: Sep 4, 2013

Recent studies:
According to Kapenhas-Valdes and coworkers, mammary ductoscopy is useful in evaluating patients who have nipple discharge, revealing papilloma in 45% of patients (42 of 93), cancer in 6.5% (6 of 93), and atypia in 6.5% (6 of 93). They noted that in their study, mammary ductoscopy was helpful for accurate visualization, analysis, and excision of intraductal abnormalities, especially deeper intraductal abnormalities.[1, 2]

Vaughan et al, in a study of 89 patients with pathologic nipple discharge, found that the combination of visualization by ductoscopy and pathologic analysis of washings provided the highest predictive value for the diagnosis of papilloma. More than 90% of patients with pathologic nipple discharge were found to have a lesion on pathologic examination when this technique was used for directed duct excision. Cellular yields were excellent, with specimens yielding more than 5,000 epithelial cells/hpf and with evaluable ductal cells in 82% of specimens.[3]

Tokuda et al found that MRI (1.5-T system) provided clinically useful data in 47 patients with suspicious nipple discharge. The MRI 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; they were compared with the histopathologic diagnoses established in 39 lesions. The most common finding was non-masslike enhancement, and 17 malignant lesions and 22 benign lesions were detected. The most frequent findings in the malignant lesions were segmental, heterogeneous, and plateau patterns. Clustered ring enhancement was found in 60% of the enhanced malignant lesions.[4]

For full article:

http://emedicine.medscape.com/article/347305-author