- In the Setting of Negative Mammogram, Is Additional Breast Ultrasound Necessary for Evaluation of Breast Pain? [Journal Article]
- CPCurr Probl Diagn Radiol 2018 Jan 09
- CONCLUSIONS: In the setting of negative mammogram and breast pain alone, additional evaluation with ultrasound is likely low yield and may be unnecessary. However, with additional symptoms such as palpable concern or nipple discharge, ultrasound is likely an important adjunct modality for identifying mammographically occult tumors.
- Managing Male Mammary Maladies. [Review]
- EJEur J Breast Health 2018; 14(1):5-9
- This review examines the symptoms, need for referral and management of the benign breast conditions which afflict males, together with the steps that are necessary to exclude or confirm male breast c...
This review examines the symptoms, need for referral and management of the benign breast conditions which afflict males, together with the steps that are necessary to exclude or confirm male breast cancer. The most common complaint is gynaecomastia, either true or pseudo, and the majority of these cases need reassurance without over-investigation. Drugs that induce breast enlargement are described in order that, when possible, a medication switch can be made. Men receiving endocrine therapy for prostate cancer may develop painful gynaecomastia and this can be relieved with tamoxifen. All men with breast cancer need mammography as part of their work-up but this should not be used as a screening technique for symptomatic males. Because of lack of lobular development, both cysts and fibroadenomas are very rare in men; but those with nipple discharge need referral and investigation as some will have underlying malignancy.
- Breast imaging in patients with nipple discharge. [Review]
- RBRadiol Bras 2017 Nov-Dec; 50(6):383-388
- Nipple discharge is a common symptom in clinical practice, representing the third leading breast complaint, after pain and lumps. It is usually limited and has a benign etiology. The risk of malignan...
Nipple discharge is a common symptom in clinical practice, representing the third leading breast complaint, after pain and lumps. It is usually limited and has a benign etiology. The risk of malignancy is higher when the discharge is uniductal, unilateral, spontaneous, persistent, bloody, or serous, as well as when it is accompanied by a breast mass. The most common causes of pathologic nipple discharge are papilloma and ductal ectasia. However, there is a 5% risk of malignancy, mainly ductal carcinoma in situ. The clinical examination is an essential part of the patient evaluation, allowing benign nipple discharge to be distinguished from suspicious nipple discharge, which calls for imaging. Mammography and ultrasound should be used together as first-line imaging methods. However, mammography has low sensitivity in cases of nipple discharge, because, typically, the lesions are small, are retroareolar, and contain no calcifications. Because the reported sensitivity and specificity of ultrasound, it is important to use the correct technique to search for intraductal lesions in the retroareolar region. Recent studies recommend the use of magnetic resonance imaging in cases of suspicious nipple discharge in which the mammography and ultrasound findings are normal. The most common magnetic resonance imaging finding is non-mass enhancement. Surgery is no longer the only solution for patients with suspicious nipple discharge, because short-time follow-up can be safely proposed.
- Implications of nipple discharge in Hong Kong Chinese women. [Journal Article]
- HKHong Kong Med J 2018; 24(1):18-24
- CONCLUSIONS: In patients with non-blood-stained nipple discharge, a negative clinical breast examination combined with negative imaging could reasonably infer a benign underlying pathology.
- Benign Breast Conditions. [Journal Article]
- JAJ Am Osteopath Assoc 2017 Dec 01; 117(12):755-760
- Breast masses and nipple discharge are common symptoms that lead women to seek medical care. Many of the findings on subsequent examination are benign. When evaluating a patient who presents with bre...
Breast masses and nipple discharge are common symptoms that lead women to seek medical care. Many of the findings on subsequent examination are benign. When evaluating a patient who presents with breast masses or nipple discharge, it is useful to take a holistic approach to evaluating the patient, including a detailed history, structural and directed physical examination, and, if indicated, laboratory studies, diagnostic imaging, and biopsy. The goal of this review is to assist physicians in understanding the evaluation, diagnosis, and management of benign breast conditions.
- Indicators of breast cancer in patients undergoing microdochectomy for a pathological nipple discharge in a middle-income country. [Journal Article]
- JSJ Surg Res 2017; 220:336-340
- CONCLUSIONS: In our population, a bloody discharge in women aged 55 years or older should mandate a microdochectomy, with selective surgery for younger women and those with nonbloody discharges. Thorough clinical examination to determine the true color and nature of the discharge is vital in the initial assessment of these patients. Preoperative radiology is not helpful in determining the presence of cancer (in an isolated pathological nipple discharge), and microdochectomy still remains the gold standard in diagnosing cancer in these patients.
- Management of benign papilloma without atypia diagnosed at ultrasound-guided core needle biopsy: Scoring system for predicting malignancy. [Journal Article]
- EJEur J Surg Oncol 2018; 44(1):53-58
- CONCLUSIONS: A scoring system predicting malignancy in patients diagnosed by CNB with benign papilloma without atypia was developed. This system was able to identify a subset of patients with lesions likely to be benign, indicating that imaging follow-up rather than surgical excision may be appropriate.
- [Neonatal herpes: Epidemiology, clinical manifestations and management. Guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF)]. [Journal Article]
- GOGynecol Obstet Fertil Senol 2017; 45(12):691-704
- CONCLUSIONS: Neonatal herpes is a rare disease with a high morbidity and mortality. The management of a newborn at risk requires good coordination between the obstetric and pediatric teams and parent's information.
- Ultrasound-guided wire localization of focal ductal dilatation in the evaluation and treatment of pathologic nipple discharge. [Journal Article]
- BJBreast J 2017 Oct 24
- Patients presenting with pathologic nipple discharge (PND) often pose a diagnostic and therapeutic challenge. We used ultrasound to identify focal ductal dilatation-hypothesized to be a radiographic ...
Patients presenting with pathologic nipple discharge (PND) often pose a diagnostic and therapeutic challenge. We used ultrasound to identify focal ductal dilatation-hypothesized to be a radiographic manifestation of the causative lesion-in patients with PND and no relevant clinical or radiographic findings. Twenty-two excisions guided by ultrasound wire localization of focal duct dilation were performed. Surgical pathology revealed papilloma in 20 cases (91%); atypia or carcinoma was detected in 7 cases (32%). The ultrasound finding of focal duct dilatation enables excision of otherwise occult though clinically significant lesions and is worthy of further study.
New Search Next
- Ex vivo feasibility study of endoscopic intraductal laser ablation of the breast. [Journal Article]
- LSLasers Surg Med 2017 Oct 09
- CONCLUSIONS: We show for the first time that laser ductoscopy is technically feasible. The Thulium laser enables a superficial intraductal ablation and is a useful tool for intraductal interventions. An in vivo prospective study is needed to further demonstrate its potential. Lasers Surg. Med. © 2017 Wiley Periodicals, Inc.