Contrast enhanced breast ultrasound to differentiate papillomas from intraductal secretion : initial experience : P22

Purpose: To describe low mechanical index grey scale contrast enhanced breast ultrasound in patients with intraductal echogenic material in the differentiation of papillomas from intraductal secretions. Methods and materials: In five patients with echographically detected ductal dilatation containing echogenic material low mechanical index grey scale contrast enhanced ultrasonography was performed. No patient had nipple discharge. The examination was performed with a 9 MHz linear transducer after injection of 4 ml of Sonovue. It was assessed if contrast enhancement was present or not. The results were correlated with histologic results after surgical resection or percutaneous biopsy when performed. Results: In 3 patients contrast enhancement was observed. These patients were operated and the papillomas confirmed by histology. In two patients no contrast enhancement was observed. In one of these two patients percutaneous biopsy was performed without evidence of a papillary lesion. The second patient presented with multiple dilated ducts containing echogenic material. No biopsy was performed but breast MRI showed no intraductal enhancement supporting the non papillary nature of the intraductal material. Conclusion: This pilot study shows that contrast enhanced ultrasound is able to detect the vascularisation of papillomas and that it may differentiate intraductal papillomas from secretions.