- 期刊
Clinical Significance of Ductal Dilatation on Breast Ultrasonogram
並列摘要
Background: With the advent of high-resolution ultrasound (US), dilatation of the lactiferous ducts can be easily demonstrated at routine breast US examination. The purpose of this study was to prospectively evaluate the clinical significance of ductal dilatation detected on breast US study. Patients and Methods: During a period of 12 months, we examined 16,336 nonlactating women referred for breast US; about 2.5% of them had a known history of nipple discharge. Routine whole breast US examinations were performed by using high-resolution US scanners. More attention was paid to detect and document the dilated ducts in the breasts. Among the 16,336 nonlactating women, 478 (2.9%) had duct dilatation (defined as duct diameter＞2.0mm). Patients with dilated ducts were either followed-up for at least 2 years or were aspirated or biopsied according to their US findings. Results: Of the 478 women with duct dilatation, 387 (81.0%) had no significant internal echoes in the dilated ducts, 48 (10.0%) had low-level internal echoes inside the ducts, and 39 (8.2%) had medium-level to relatively high-level internal echoes. Solid nodules in the ducts were demonstrated in 26 (5.4%) women, and calcified material in five (1.0%). For patients with intraductal echoes, US-guided aspiration or biopsy was performed to determine the duct contents; 18 of 26 intraductal nodules were shown to be intraductal papilloma cytologically and/or histopathologically, two were shown to be intraductal carcinoma in situ, and five were epithelial hyperplasia or atypical ductal hyperplasia. The majority of the other 61 women with internal echoes were found to have inspissated secretions (50/61, 82.0%), while the remaining 11 showed no cellular component inside, but the findings were inconclusive. Conclusion: Multiple dilated ducts depicted on US are rarely associated with intraductal tumors (p＜0.001). If US can demonstrate solid nodules in the dilated duct, the possibility of intraductal tumor, especially papilloma, should be considered first. Routine and cautious evaluation of the dilated duct may depict intraductal tumor even in women without nipple discharge, and may facilitate surgical intervention without unnecessary delay.