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Breast
Lesion Imaging Characteristics
Ultrasound Lesion Characteristics
Intraductal Mass (US)
Intraductal Mass (US)
Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Mass within (usually dilated) duct
            • Overlap with intracystic masses, which typically occur in lactiferous or terminal ducts
            • Ductography: Injection of discharging duct with small volume of contrast followed by magnification craniocaudal and 90° lateral views

          IMAGING

          • General Features

            • Mammographic Findings

              • Ultrasonographic Findings

                • Ductography

                  • MR Findings

                    • CT Findings

                      • Imaging Recommendations

                        • Nuclear Medicine Findings

                          • Image-Guided Biopsy

                            DIFFERENTIAL DIAGNOSIS

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          • Reporting Tips

                                            Selected References

                                            1. Guo Y et al: Retroareolar masses and intraductal abnormalities detected on screening ultrasound: can biopsy be avoided? Br J Radiol. 20170816, 2018
                                            2. Kim WH et al: Intraductal mass on breast ultrasound: final outcomes and predictors of malignancy. AJR Am J Roentgenol. 200(4):932-7, 2013
                                            3. Ferris-James DM et al: Imaging approaches to diagnosis and management of common ductal abnormalities. Radiographics. 32(4):1009-30, 2012
                                            4. Lu Q et al: Surgical excision of intraductal breast papilloma diagnosed on core biopsy. ANZ J Surg. 82(3):168-72, 2012
                                            5. Chang JM et al: Management of ultrasonographically detected benign papillomas of the breast at core needle biopsy. AJR Am J Roentgenol. 196(3):723-9, 2011
                                            6. Chang JM et al: Papillary lesions initially diagnosed at ultrasound-guided vacuum-assisted breast biopsy: rate of malignancy based on subsequent surgical excision. Ann Surg Oncol. 18(9):2506-14, 2011
                                            7. Richter-Ehrenstein C et al: Intraductal papillomas of the breast: diagnosis and management of 151 patients. Breast. 20(6):501-4, 2011
                                            8. Tominaga J et al: Magnetic resonance imaging of intraductal papillomas of the breast. J Comput Assist Tomogr. 35(1):153-7, 2011
                                            9. Chang CB et al: Solitary dilated duct identified at mammography: outcomes analysis. AJR Am J Roentgenol. 194(2):378-82, 2010
                                            10. Jung SY et al: Risk factors for malignancy in benign papillomas of the breast on core needle biopsy. World J Surg. 34(2):261-5, 2010
                                            11. Ahmadiyeh N et al: Management of intraductal papillomas of the breast: an analysis of 129 cases and their outcome. Ann Surg Oncol. 16(8):2264-9, 2009
                                            12. Chang JM et al: Does ultrasound-guided directional vacuum-assisted removal help eliminate abnormal nipple discharge in patients with benign intraductal single mass? Korean J Radiol. 10(6):575-80, 2009
                                            13. Ganesan S et al: Ultrasound spectrum in intraductal papillary neoplasms of breast. Br J Radiol. 79(946):843-9, 2006
                                            14. Liberman L et al: Is surgical excision warranted after benign, concordant diagnosis of papilloma at percutaneous breast biopsy? AJR Am J Roentgenol. 186(5):1328-34, 2006
                                            15. Mercado CL et al: Papillary lesions of the breast at percutaneous core-needle biopsy. Radiology. 238(3):801-8, 2006
                                            16. Valdes EK et al: Significance of papillary lesions at percutaneous breast biopsy. Ann Surg Oncol. 13(4):480-2, 2006
                                            17. Dennis MA et al: Incidental treatment of nipple discharge caused by benign intraductal papilloma through diagnostic Mammotome biopsy. AJR Am J Roentgenol. 174(5):1263-8, 2000
                                            18. Orel SG et al: MR imaging in patients with nipple discharge: initial experience. Radiology. 216(1):248-54, 2000
                                            19. Hild F et al: Ductal orientated sonography improves the diagnosis of pathological nipple discharge of the female breast compared with galactography. Eur J Cancer Prev. 7 Suppl 1:S57-62, 1998
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Mass within (usually dilated) duct
                                                      • Overlap with intracystic masses, which typically occur in lactiferous or terminal ducts
                                                      • Ductography: Injection of discharging duct with small volume of contrast followed by magnification craniocaudal and 90° lateral views

                                                    IMAGING

                                                    • General Features

                                                      • Mammographic Findings

                                                        • Ultrasonographic Findings

                                                          • Ductography

                                                            • MR Findings

                                                              • CT Findings

                                                                • Imaging Recommendations

                                                                  • Nuclear Medicine Findings

                                                                    • Image-Guided Biopsy

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  • Image Interpretation Pearls

                                                                                    • Reporting Tips

                                                                                      Selected References

                                                                                      1. Guo Y et al: Retroareolar masses and intraductal abnormalities detected on screening ultrasound: can biopsy be avoided? Br J Radiol. 20170816, 2018
                                                                                      2. Kim WH et al: Intraductal mass on breast ultrasound: final outcomes and predictors of malignancy. AJR Am J Roentgenol. 200(4):932-7, 2013
                                                                                      3. Ferris-James DM et al: Imaging approaches to diagnosis and management of common ductal abnormalities. Radiographics. 32(4):1009-30, 2012
                                                                                      4. Lu Q et al: Surgical excision of intraductal breast papilloma diagnosed on core biopsy. ANZ J Surg. 82(3):168-72, 2012
                                                                                      5. Chang JM et al: Management of ultrasonographically detected benign papillomas of the breast at core needle biopsy. AJR Am J Roentgenol. 196(3):723-9, 2011
                                                                                      6. Chang JM et al: Papillary lesions initially diagnosed at ultrasound-guided vacuum-assisted breast biopsy: rate of malignancy based on subsequent surgical excision. Ann Surg Oncol. 18(9):2506-14, 2011
                                                                                      7. Richter-Ehrenstein C et al: Intraductal papillomas of the breast: diagnosis and management of 151 patients. Breast. 20(6):501-4, 2011
                                                                                      8. Tominaga J et al: Magnetic resonance imaging of intraductal papillomas of the breast. J Comput Assist Tomogr. 35(1):153-7, 2011
                                                                                      9. Chang CB et al: Solitary dilated duct identified at mammography: outcomes analysis. AJR Am J Roentgenol. 194(2):378-82, 2010
                                                                                      10. Jung SY et al: Risk factors for malignancy in benign papillomas of the breast on core needle biopsy. World J Surg. 34(2):261-5, 2010
                                                                                      11. Ahmadiyeh N et al: Management of intraductal papillomas of the breast: an analysis of 129 cases and their outcome. Ann Surg Oncol. 16(8):2264-9, 2009
                                                                                      12. Chang JM et al: Does ultrasound-guided directional vacuum-assisted removal help eliminate abnormal nipple discharge in patients with benign intraductal single mass? Korean J Radiol. 10(6):575-80, 2009
                                                                                      13. Ganesan S et al: Ultrasound spectrum in intraductal papillary neoplasms of breast. Br J Radiol. 79(946):843-9, 2006
                                                                                      14. Liberman L et al: Is surgical excision warranted after benign, concordant diagnosis of papilloma at percutaneous breast biopsy? AJR Am J Roentgenol. 186(5):1328-34, 2006
                                                                                      15. Mercado CL et al: Papillary lesions of the breast at percutaneous core-needle biopsy. Radiology. 238(3):801-8, 2006
                                                                                      16. Valdes EK et al: Significance of papillary lesions at percutaneous breast biopsy. Ann Surg Oncol. 13(4):480-2, 2006
                                                                                      17. Dennis MA et al: Incidental treatment of nipple discharge caused by benign intraductal papilloma through diagnostic Mammotome biopsy. AJR Am J Roentgenol. 174(5):1263-8, 2000
                                                                                      18. Orel SG et al: MR imaging in patients with nipple discharge: initial experience. Radiology. 216(1):248-54, 2000
                                                                                      19. Hild F et al: Ductal orientated sonography improves the diagnosis of pathological nipple discharge of the female breast compared with galactography. Eur J Cancer Prev. 7 Suppl 1:S57-62, 1998
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