Ductography If patient history and physical examination demonstrate physiologic nipple discharge and routine screening mammography is up to date, no further radiologic investigation is needed [28,29]. MRI Breast If patient history and physical examination demonstrate physiologic nipple discharge and routine screening mammography is up to date, no further radiologic investigation is needed [28,29]. FDG-PET Breast Dedicated If patient history and physical examination demonstrate physiologic nipple discharge and routine screening mammography is up to date, no further radiologic investigation is needed [28,29]. Image-guided Core Biopsy Breast Image-guided core biopsy is not required for the evaluation of physiologic nipple discharge in the female patient. Image-Guided Fine Needle Aspiration Breast Image-guided fine-needle aspiration (FNA) is not required for the evaluation of physiologic nipple discharge in the female patient. Sestamibi MBI If patient history and physical examination demonstrate physiologic nipple discharge and routine screening mammography is up to date, no further radiologic investigation is needed [28,29]. Evaluation of Nipple Discharge Variant 2: Adult male or female 40 years of age or older. Pathologic nipple discharge. Initial imaging. Mammography Diagnostic Mammography is the first-line imaging modality for evaluation of pathologic nipple discharge in male and female patients in this age group [30]. Although 3% to 29% of pathologic nipple discharge is due to an underlying breast cancer, full-field mammography often does not demonstrate these lesions because they may be very small, contain no calcifications, or are completely intraductal [1-3]. To better evaluate the subareolar breast in patients with an asymmetry/focal asymmetry or suspicious microcalcifications, additional mammographic views with spot compression and magnification may be needed [31]. Most cases of pathologic nipple discharge are due to a benign intraductal papilloma [32].
Evaluation of Nipple Discharge. Ductography If patient history and physical examination demonstrate physiologic nipple discharge and routine screening mammography is up to date, no further radiologic investigation is needed [28,29]. MRI Breast If patient history and physical examination demonstrate physiologic nipple discharge and routine screening mammography is up to date, no further radiologic investigation is needed [28,29]. FDG-PET Breast Dedicated If patient history and physical examination demonstrate physiologic nipple discharge and routine screening mammography is up to date, no further radiologic investigation is needed [28,29]. Image-guided Core Biopsy Breast Image-guided core biopsy is not required for the evaluation of physiologic nipple discharge in the female patient. Image-Guided Fine Needle Aspiration Breast Image-guided fine-needle aspiration (FNA) is not required for the evaluation of physiologic nipple discharge in the female patient. Sestamibi MBI If patient history and physical examination demonstrate physiologic nipple discharge and routine screening mammography is up to date, no further radiologic investigation is needed [28,29]. Evaluation of Nipple Discharge Variant 2: Adult male or female 40 years of age or older. Pathologic nipple discharge. Initial imaging. Mammography Diagnostic Mammography is the first-line imaging modality for evaluation of pathologic nipple discharge in male and female patients in this age group [30]. Although 3% to 29% of pathologic nipple discharge is due to an underlying breast cancer, full-field mammography often does not demonstrate these lesions because they may be very small, contain no calcifications, or are completely intraductal [1-3]. To better evaluate the subareolar breast in patients with an asymmetry/focal asymmetry or suspicious microcalcifications, additional mammographic views with spot compression and magnification may be needed [31]. Most cases of pathologic nipple discharge are due to a benign intraductal papilloma [32].