Diagnosis of papillomas of the breast: value of magnetic resonance mammography in comparison with galactography

The aim of this study was evaluation of MRI alone and in combination with m ammography and galactography in the diagnosis of intraductal pa-as. From 19 94 to 1998, a total of 48 women pre-ting with pathologic mammary secretion under galactography and magnetic resonance mammography (MRM). Thirty-five p atients aged years (average age 46 years) subsequently underwent surgery or diagnostic puncture and the histologic findings were compared with the res ults of the radiologic examination. Histology revealed papillomas in 16 cas es. In 6 of these patients, there was associated malignant degeneration. Ma lignancy without associated papilloma was observed in 3 cases. Galactograph y displayed a sensitivity of 94% and a specificity of 79% with five false-p ositive findings and one = false-negative finding in the recognition of int raductal papillomas. Malignant processes were detected mammography/galactog raphy in only one instance. Magnetic resonance mammography visualized patho logic contrast medium uptake in 8 of 9 cases of malignant disease (sensitiv ity 89%). One patient with in situ ductal carcinoma escaped detection with MRM. Papillomas showed no or below-threshold-lying contrast uptakes with no specific sign suggestive of papilloma. Galactography in combination with m ammography remains the primary diagnostic procedure in cases of pathologic mammary secretion or suspected papilloma. The addition of MRI permits exclu sion of malignant disease with a high degree of certainty; thus, expectant management in individual cases with negative findings appears justified.