Management of breast nipple discharge : Recommendations
Copyright © 2015 Elsevier Masson SAS. All rights reserved..
OBJECTIVES: To investigate diagnostic value of imaging procedures and management strategies of the patients with nipple discharge (ND) to establish management recommendations.
METHODS: Bibliographical search in French and English languages by consultation of PubMed, Cochrane and Embase databases.
RESULTS: Although, all ND require an systematic evaluation guided by clinical data, bloody ND could be a predictor of breast cancer risk among different colors of discharge particularly in patients of more than 50 years (LE2). The mammography and breast ultrasography are the imaging procedures to realize in first intention (grade C) but they turn out useful only when they detect radiological abnormalities (LE4). Galactography has only a localizing value of possible ductal abnormalities (when standard imaging procedures is not contributive) (LE4). Thus, in the diagnostic investigation of a suspicious ND, galactography it is not recommended in standard practice (grade C). The breast Magnetic Resonance Imaging (MRI) is recommended when breast standard imaging procedures are not contributive (grade C). The ND cytology is useful only if it is positive (i.e. reveal cancer cells). There is no proof on the diagnostic performance of the cytological analysis of the ND to allow a recommendation on its realization or not. In front of a suspicious ND, when breast-imaging procedures reveals an associated radiological lesion, an adapted percutaneous biopsy is recommended by percutaneous way (grade C). Vacuum-assisted breast biopsies is a diagnostic tool but can also be therapeutic allowing to avoid surgery in case of benign lesion but current literature data do not allow recommendations on the therapeutic aspect of vacuum-assisted breast biopsy (LE4). In the absence of associated radiological signal, and in case of reproducible bloody persistent ND, a pyramidectomy is recommended (grade C).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:44 |
|---|---|
| Enthalten in: |
Journal de gynecologie, obstetrique et biologie de la reproduction - 44(2015), 10 vom: 01. Dez., Seite 927-37 |
| Sprache: |
Französisch |
|---|
| Weiterer Titel: |
Exploration d'un écoulement mamelonnaire du sein uni- ou bilatéral: recommandations |
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| Beteiligte Personen: |
Ouldamer, L [VerfasserIn] |
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| Links: |
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| Themen: |
Écoulement mamelonnaire |
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| Anmerkungen: |
Date Completed 15.09.2016 Date Revised 26.11.2016 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jgyn.2015.09.035 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM254417469 |
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| 500 | |a Date Revised 26.11.2016 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2015 Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a OBJECTIVES: To investigate diagnostic value of imaging procedures and management strategies of the patients with nipple discharge (ND) to establish management recommendations | ||
| 520 | |a METHODS: Bibliographical search in French and English languages by consultation of PubMed, Cochrane and Embase databases | ||
| 520 | |a RESULTS: Although, all ND require an systematic evaluation guided by clinical data, bloody ND could be a predictor of breast cancer risk among different colors of discharge particularly in patients of more than 50 years (LE2). The mammography and breast ultrasography are the imaging procedures to realize in first intention (grade C) but they turn out useful only when they detect radiological abnormalities (LE4). Galactography has only a localizing value of possible ductal abnormalities (when standard imaging procedures is not contributive) (LE4). Thus, in the diagnostic investigation of a suspicious ND, galactography it is not recommended in standard practice (grade C). The breast Magnetic Resonance Imaging (MRI) is recommended when breast standard imaging procedures are not contributive (grade C). The ND cytology is useful only if it is positive (i.e. reveal cancer cells). There is no proof on the diagnostic performance of the cytological analysis of the ND to allow a recommendation on its realization or not. In front of a suspicious ND, when breast-imaging procedures reveals an associated radiological lesion, an adapted percutaneous biopsy is recommended by percutaneous way (grade C). Vacuum-assisted breast biopsies is a diagnostic tool but can also be therapeutic allowing to avoid surgery in case of benign lesion but current literature data do not allow recommendations on the therapeutic aspect of vacuum-assisted breast biopsy (LE4). In the absence of associated radiological signal, and in case of reproducible bloody persistent ND, a pyramidectomy is recommended (grade C) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Biopsie | |
| 650 | 4 | |a Biopsy | |
| 650 | 4 | |a Breast cancer | |
| 650 | 4 | |a Cancer du sein | |
| 650 | 4 | |a IRM | |
| 650 | 4 | |a MRI | |
| 650 | 4 | |a Nipple discharge | |
| 650 | 4 | |a Pyramidectomie | |
| 650 | 4 | |a Pyramidectomy | |
| 650 | 4 | |a Écoulement mamelonnaire | |
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| 700 | 1 | |a Chopier, J |e verfasserin |4 aut | |
| 700 | 1 | |a Body, G |e verfasserin |4 aut | |
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