Mammographically occult, fluid producing carcinoma cases originating in the major ducts. The results of the multimodality workup are compared with large format thin and thick section histopathology.
Three consecutive lectures complete our lecture series dealing with fluid producing breast cancers of ductal origin. The unique feature of these cases is the presence of serous or bloody nipple discharge, while the extensive disease may be occult for mammography. It is the cancer cells - having micropapillary and/or cribriform tumor growth pattern - that produce the fluid. Due to lack of stagnation of the fluid within the ducts, no microcalcifications are formed, explaining why the extensive disease is occult on the mammogram. The best examination method is galactography (ductography), which provides the highest resolution and most accurate assessment of the disease extent. Combining breast MRI and galactography may provide complementary information. Using only breast MRI is the least recommended examination method due to the low spatial resolution of breast MRI. This lecture series consists of a large number of cases where the results of the different imaging tools are compared with large format thin and thick section histopathology.