Ultrasound-guided wire localization of focal ductal dilatation in the evaluation and treatment of pathologic nipple discharge.

Patients presenting with pathologic nipple discharge (PND) often pose a diagnostic and therapeutic challenge. We used ultrasound to identify focal ductal dilatation-hypothesized to be a radiographic manifestation of the causative lesion-in patients with PND and no relevant clinical or radiographic findings. Twenty-two excisions guided by ultrasound wire localization of focal duct dilation were performed. Surgical pathology revealed papilloma in 20 cases (91%); atypia or carcinoma was detected in 7 cases (32%). The ultrasound finding of focal duct dilatation enables excision of otherwise occult though clinically significant lesions and is worthy of further study.