MR imaging in patients with nipple discharge: Initial experience

PURPOSE: To investigate the potential of magnetic resonance (MR) imaging in patients with nipple discharge. MATERIALS AND METHODS: Between February 1992 and December 1998, 23 patients with nipple discharge underwent contrast material-enhanced MR imaging at 1 .5 T. Mammographic findings were negative in 22 of 23 patients and revealed asymmetry in one patient. Galactography was attempted in two patients, wit h negative findings in one patient and no success in the other. Fifteen of 23 patients underwent excisional biopsy-seven of 15 with MR imaging-guided localization, and one of 15 with mammographic localization. Eight of 23 pat ients were followed up clinically (range, 7-24 months; mean, 20 months). RESULTS: In 11 of the 15 (73%) patients who underwent excisional biopsy, MR imaging findings correlated with histopathologic findings. MR imaging demo nstrated four of six benign papillomas and one of two fibroadenomas as circ umscribed, enhancing subareolar masses. Findings of one MR imaging examinat ion were negative, and benign tissue was found at excisional biopsy. MR ima ging findings were suspicious in six of the seven patients with excisional biopsy findings of malignancy (regional enhancement [n = 2], ductal enhance ment in = 2], peripherally enhancing mass [n = 1], and spiculated mass [n = 1]). In one of the seven patients, a benign-appearing intraductal mass was identified at MR imaging; excisional biopsy revealed a benign papilloma wi th an adjacent focus of DCIS. CONCLUSION: MR imaging can help identify both benign and malignant causes o f nipple discharge. It potentially offers a noninvasive alternative to gala ctography.