MRI Breast There is no relevant literature to support the use of MRI for the evaluation of male patients with nipple discharge. FDG-PET Breast Dedicated There is no relevant literature to support the use of FDG-PET for the evaluation of male patients with nipple discharge. Image-guided Core Biopsy Breast There is no relevant literature to support the use of core biopsy for the evaluation of male patients with nipple discharge. However, if an imaging abnormality is identified, US may be used to direct biopsy. Image-Guided Fine Needle Aspiration Breast There is no relevant literature to support the use of image-guided FNA for the evaluation of male patients with nipple discharge. Sestamibi MBI There is no relevant literature to support the use of MBI for the evaluation of male patients with nipple discharge. Variant 5: Adult female younger than 30 years of age. Pathologic nipple discharge. Initial imaging. The probability of a woman developing breast cancer over the next decade increases with age; the risk is 1 in 1,681 at 20 years of age, 1 in 232 at 30 years of age, and 1 in 69 at 40 years of age [62]. Breast cancer is rare in women <30 years of age, with the exception of those with a genetic predisposition or prior mantle radiation to the chest. In a study by Seltzer et al [66] on the significance of age in patients with nipple discharge, malignancy was found in 1 of 10 patients <30 years of age. However, caution should be exercised interpreting these results given a very small sample size and the possible inclusion of high-risk patients. Mammography Diagnostic Most breast lesions in young women are not visualized on mammography [67,68] because of the low incidence of breast cancer (0.4% or lower) in women <30 years of age. US is most useful for initial imaging in this population; however, diagnostic mammography may be useful when US shows a suspicious finding.
Evaluation of Nipple Discharge. MRI Breast There is no relevant literature to support the use of MRI for the evaluation of male patients with nipple discharge. FDG-PET Breast Dedicated There is no relevant literature to support the use of FDG-PET for the evaluation of male patients with nipple discharge. Image-guided Core Biopsy Breast There is no relevant literature to support the use of core biopsy for the evaluation of male patients with nipple discharge. However, if an imaging abnormality is identified, US may be used to direct biopsy. Image-Guided Fine Needle Aspiration Breast There is no relevant literature to support the use of image-guided FNA for the evaluation of male patients with nipple discharge. Sestamibi MBI There is no relevant literature to support the use of MBI for the evaluation of male patients with nipple discharge. Variant 5: Adult female younger than 30 years of age. Pathologic nipple discharge. Initial imaging. The probability of a woman developing breast cancer over the next decade increases with age; the risk is 1 in 1,681 at 20 years of age, 1 in 232 at 30 years of age, and 1 in 69 at 40 years of age [62]. Breast cancer is rare in women <30 years of age, with the exception of those with a genetic predisposition or prior mantle radiation to the chest. In a study by Seltzer et al [66] on the significance of age in patients with nipple discharge, malignancy was found in 1 of 10 patients <30 years of age. However, caution should be exercised interpreting these results given a very small sample size and the possible inclusion of high-risk patients. Mammography Diagnostic Most breast lesions in young women are not visualized on mammography [67,68] because of the low incidence of breast cancer (0.4% or lower) in women <30 years of age. US is most useful for initial imaging in this population; however, diagnostic mammography may be useful when US shows a suspicious finding.