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Breast intraductal masses: US-guided fine-needle aspiration after galactography
F Sardanelli1, A Imperiale, F Zandrino
1Department of Radiology, University of Genoa, San Martino Hospital, Italy.
Insights
Ultrasonography (US)-guided fine-needle aspiration (FNA) after galactography improved diagnostic accuracy for intraductal breast masses compared to nipple discharge analysis. This technique aids in better surgical planning for breast conditions.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Nipple discharge can indicate underlying intraductal breast pathology.
- Galactography is used to visualize intraductal lesions, but further cytologic confirmation is often needed.
Purpose of the Study:
- To assess the diagnostic utility of ultrasonography (US)-guided fine-needle aspiration (FNA) performed immediately after galactography for intraductal breast masses.
- To compare the cytologic accuracy of US-guided FNA with that of nipple discharge analysis.
Main Methods:
- 36 patients with single-duct nipple discharge and galactographically diagnosed intraductal masses underwent US-guided FNA post-galactography.
- Cytologic analysis of nipple discharge, FNA samples, and subsequent histopathology were performed.
Main Results:
- US-guided FNA correctly diagnosed 50% of cases, significantly higher than the 25% accuracy of nipple discharge analysis (P = .0352).
- US-guided FNA identified three carcinomas, including invasive types, whereas nipple discharge analysis detected only one.
- Two papillary in situ carcinomas were initially misdiagnosed as papillomas by US-guided FNA.
Conclusions:
- US-guided FNA, performed after galactography, provides valuable diagnostic information for intraductal breast lesions.
- This technique enhances diagnostic accuracy compared to nipple discharge analysis, supporting tailored surgical planning.
Purpose:
To evaluate ultrasonographic (US)-guided fine-needle aspiration (FNA) of intraductal masses performed immediately after galactography and to compare cytologic findings from US-guided FNA with those from nipple discharge.
Materials And Methods:
In 36 patients with nipple discharge from a single duct in one breast and intraductal masses diagnosed at galactography, US was performed to detect intraductal lesions and perform FNA before removal of the galactographic catheter. Cytologic analysis of nipple discharge, excisional biopsy, and histopathologic evaluation were performed in all patients.
Results:
Cytologic analysis revealed 23 nonpapillary benignancies, seven papillomas, five indeterminate cases, and one carcinoma. US-guided FNA cytologic analysis revealed 16 papillomas, 10 nonpapillary benignancies, five indeterminate cases, and three carcinomas. The two carcinomas misdiagnosed as papillomas at US-guided FNA cytologic analysis were papillary in situ carcinomas, while the three carcinomas correctly identified were invasive (only one was detected with cytologic analysis of nipple discharge). With cytologic analysis of nipple discharge, nine (25%) of 36 diagnoses were correct, and with US-guided FNA, 18 (50%) were correct (P = .0352).
Conclusion:
Compared with cytologic analysis of nipple discharge, US-guided FNA cytologic analysis seems to add useful information for tailored surgical planning.