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26 - MRI and galactography of patients with nipple discharge

Galactography and MRI demonstrate the presence of the disease as there are no calcifications or other mammographic findings.

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Nipple discharge as the only sign of the underlying disease presents a challenge to the imager. The most frequent cause of nipple discharge in benign papilloma, but the most important cause of bloody or serous nipple discharge is the extensive micropapillary/cribriform carcinoma developing in the major lactiferous ducts. It may be occult on mammography. The galactogram shows neoductgenesis and innumerable, tiny filling defects corresponding to the small micropapillary growths causing the discharge.

Correlation between the galactogram and breast MRI is demonstrated in this lecture, case after case. The spatial resolution of the galactogram is higher than that of the MRI. Large format thin and thick section histopathology images clearly demonstrate the underlying cause of the discharge and the full extent of the disease.

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