title: Breast MRI in patients with unilateral bloody and serous-bloody nipple discharge: a comparison with galactography.
abstract: OBJECTIVE
  Assessing the role of breast MRI compared to galactography in patients with unilateral bloody or serous-bloody nipple discharge.
  
  
  METHODS
  Retrospective study including 53 unilateral discharge patients who performed galactography and MRI. We evaluated the capability of both techniques in identifying pathology and distinguishing between nonmalignant and malignant lesions. Lesions BIRADS 1/2 underwent follow-up, while the histological examination after surgery has been the gold standard to assess pathology in lesions BIRADS 3/4/5. The ROC analysis was used to test diagnostic MRI and galactography ability.
  
  
  RESULTS
  After surgery and follow-up, 8 patients had no disease (15%), 23 papilloma (43%), 11 papillomatosis (21%), 5 ductal cancer in situ (10%), and 6 papillary carcinoma (11%) diagnoses. Both techniques presented 100% specificity; MRI sensitivity was 98% versus 49% of galactography. Considering MRI, we found a statistical association between mass enhancement and papilloma (P < 0.001; AUC 0.957; CI 0.888-1.025), ductal enhancement and papillomatosis (P < 0.001; AUC 0.790; CI 0.623-0.958), segmental enhancement and ductal cancer in situ (P = 0.007; AUC 0.750; CI 0.429-1.071), and linear enhancement and papillary cancer (P = 0.011).
  
  
  CONCLUSIONS
  MRI is a valid tool to detect ductal pathologies in patients with suspicious bloody or serous-bloody discharge showing higher sensitivity and specificity compared to galactography.
authors: Department of Radiological Sciences, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy.
authors: Lucia
authors: L
authors: Manganaro
authors: Department of Radiological Sciences, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy.
authors: Ilaria
authors: I
authors: D'Ambrosio
authors: Department of Radiological Sciences, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy.
authors: Silvia
authors: S
authors: Gigli
authors: Department of Radiological Sciences, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy.
authors: Francesca
authors: F
authors: Di Pastena
authors: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
authors: Guglielmo
authors: 0000-0001-8307-6921
authors: G
authors: Giraldi
authors: Department of Radiological Sciences, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy.
authors: Stefano
authors: S
authors: Tardioli
authors: Department of Gynecology and Obstetrics, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy.
authors: Marialuisa
authors: M
authors: Framarino
authors: Department of Radiological Sciences, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy.
authors: Lucio Maria
authors: 0000-0002-5505-3770
authors: LM
authors: Porfiri
authors: Department of Radiological Sciences, Sapienza University of Rome, Umberto I Hospital, Viale Regina Elena 324, 00161 Rome, Italy.
authors: Laura
authors: L
authors: Ballesio
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009558:Nipples / Q000000981:diagnostic imaging* / Q000601:surgery; D010212:Papilloma / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography