title: Value of mammography and breast ultrasound in male patients with nipple discharge.
abstract: OBJECTIVE
  To assess the contribution of mammography and ultrasound in men with nipple discharge.
  
  
  METHODS
  All men with nipple discharge who underwent mammography and/or ultrasound between 1993 and 2011 in our hospital were retrospectively evaluated. Radiological findings were classified according to BI-RADS lexicon. The final diagnosis was made based on histopathological results or clinical-radiological follow-up. The diagnostic performance of physical examination, mammography and ultrasound was calculated and compared.
  
  
  RESULTS
  26 men with 21 mammograms and 19 ultrasounds were reviewed. The final diagnoses were: 6 carcinomas (23.1%), 10 gynaecomastias, 2 pseudogynaecomastias and 8 normal breast tissues. Mammograms and ultrasounds performed on all five patients with infiltrating carcinoma showed a mass (categories 4 and 5). In all these patients except one, a breast mass was also noted and the physical examination was positive or suspected malignancy. In the patient with carcinoma in situ, the only conspicuous clinical sign was bloody nipple discharge and the mammography showed calcifications (category 4) that were not visible on ultrasound. Radiological findings of all patients without malignancy were classified as categories 1 and 2. The diagnostic performance of physical examination was lower than mammography and ultrasound (P>0.05). Mammography was more sensitive than ultrasound (100% vs. 83.3%). Both techniques showed the same specificity (100%).
  
  
  CONCLUSIONS
  Men with nipple discharge have a high incidence of breast carcinoma. Nipple discharge may be the only clinical sign of carcinoma in situ. Mammography and ultrasound are useful in the evaluation of men with nipple discharge, diagnosing carcinoma in initial stages, avoiding unnecessary biopsies.
authors.affiliation: Department of Radiology, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n, 14004 Córdoba, Spain. rafaelamunozc@hotmail.com
authors.forename: Rafaela
authors.initials: R
authors.lastname: Muñoz Carrasco
authors.forename: Marina
authors.initials: M
authors.lastname: Álvarez Benito
authors.forename: Eleonor
authors.initials: E
authors.lastname: Rivin del Campo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018567:Breast Neoplasms, Male / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009558:Nipples / Q000000981:diagnostic imaging*; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult