MRI characteristics of intraductal papilloma.
BACKGROUND
Intraductal papilloma (IDP) is the most common pathological finding in women with pathological nipple discharge. Magnetic resonance imaging (MRI) has shown potential for characterizing breast tumors; however, MRI findings of IDPs are inconclusive, and certain diagnostic standards are lacking.


OBJECTIVE
To characterize the MRI features of IDP from a relatively large cohort.


METHODS
We retrospectively reviewed from 358 women with IDPs that were confirmed by histopathology. The clinical and imaging findings in 70 patients who underwent preoperative MRI were analyzed. MRI analyses included morphology and dynamic contrast-enhanced MRI.


RESULTS
In 70 patients, 77 IDPs were detected on MRI, which revealed the following three patterns: small luminal mass papillomas; tumor-like papillomas; and MRI-occult papillomas. Fourteen IDPs involved small, oval, smooth, and contrast-enhanced masses at the posterior end of the enlarged duct corresponding to small luminal mass papillomas. Seven IDPs had large diameters along the direction of the breast duct, indicating the typical MRI findings for IDP. Of 47 tumor-like papillomas, 16 cases showed large diameters along the direction of the breast duct and close to the nipple (within 4 cm), seven cases resembled invasive breast cancer on MRI, and the remaining 24 were (24/47) undistinguishable from other benign breast diseases. Sixteen IDPs were MRI-occult papillomas that could not be distinguished from the surrounding benign disease by either contrast-enhanced MRI or fat-suppressed T2-weighted MRI.


CONCLUSIONS
Small luminal mass papillomas or tumor-like papillomas with the largest diameters along the direction of the breast duct and close to the nipple (within 4 cm) might be the typical MRI findings for IDPs.
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
Wei
W
Wang
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
Jianhui
J
Ding
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, PR China.
Wentao
W
Yang
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, PR China.
Yuan
Y
Li
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
Liangping
L
Zhou
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
Shengjian
S
Zhang
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
Hui
H
Zhu
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
Jian
J
Mao
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
Jie
J
Tang
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China yajiagu601@163.com.
Yajia
Y
Gu
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
Weijun
W
Peng
D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis*; D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D018300:Papilloma, Intraductal / Q000175:diagnosis*; D012189:Retrospective Studies
D003287:Contrast Media; D019786:Gadolinium DTPA
Intraductal papilloma; breast; magnetic resonance imaging