Persistent post-galactogram intraductal iodinated contrast detected on contrast-enhanced mammography (CEM) in a patient with nipple discharge
Nipple discharge is a common complaint among adult women and is often evaluated by galactography. Contrast-enhanced mammography (CEM) is an emerging breast imaging modality that is useful in the evaluation of patients with nipple discharge who have a negative galactogram, especially if they are not...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-04-01
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| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043322000383 |
| _version_ | 1818987567352119296 |
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| author | Shao Zun Chen, MD Timothy B. Rooney, MD Matthew M. Miller, MD, PhD |
| author_facet | Shao Zun Chen, MD Timothy B. Rooney, MD Matthew M. Miller, MD, PhD |
| author_sort | Shao Zun Chen, MD |
| collection | DOAJ |
| description | Nipple discharge is a common complaint among adult women and is often evaluated by galactography. Contrast-enhanced mammography (CEM) is an emerging breast imaging modality that is useful in the evaluation of patients with nipple discharge who have a negative galactogram, especially if they are not good candidates for contrast-enhanced MRI. Here we present a case of a 37-year-old female who was 22 weeks pregnant and presented with suspicious nipple discharge. The patient initially underwent galactography, which was negative, and was subsequently referred for CEM for further evaluation. One week after the galactogram, the patient underwent CEM which revealed persistent intraductal iodinated contrast from the galactogram. The retained intraductal contrast obscured the area of concern on the CEM and limited evaluation for underlying areas of enhancement. Given the increasing popularity of CEM in breast imaging practice and its utility in the evaluation of patients with nipple discharge, recognition of retained intraductal contrast as a source of artifact on CEM is important so that steps can be taken to prevent acquiring a limited and/or non–diagnostic CEM. We suggest several practical steps the radiologist can take when planning the diagnostic workup of patients with nipple discharge to ensure the patient will be able to successfully undergo CEM, if needed. These steps will help reduce unnecessary patient exposure to radiation and intravenous contrast and avoid a delay in diagnosis and treatment. |
| first_indexed | 2024-12-20T19:08:44Z |
| format | Article |
| id | doaj.art-ad986cb685d3481b826127489b679c61 |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-12-20T19:08:44Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-ad986cb685d3481b826127489b679c612022-12-21T19:29:14ZengElsevierRadiology Case Reports1930-04332022-04-0117410991103Persistent post-galactogram intraductal iodinated contrast detected on contrast-enhanced mammography (CEM) in a patient with nipple dischargeShao Zun Chen, MD0Timothy B. Rooney, MD1Matthew M. Miller, MD, PhD2Corresponding author; University of Virginia Medical Center, 1215 Lee Street, Charlottesville, VA 22903, USAUniversity of Virginia Medical Center, 1215 Lee Street, Charlottesville, VA 22903, USAUniversity of Virginia Medical Center, 1215 Lee Street, Charlottesville, VA 22903, USANipple discharge is a common complaint among adult women and is often evaluated by galactography. Contrast-enhanced mammography (CEM) is an emerging breast imaging modality that is useful in the evaluation of patients with nipple discharge who have a negative galactogram, especially if they are not good candidates for contrast-enhanced MRI. Here we present a case of a 37-year-old female who was 22 weeks pregnant and presented with suspicious nipple discharge. The patient initially underwent galactography, which was negative, and was subsequently referred for CEM for further evaluation. One week after the galactogram, the patient underwent CEM which revealed persistent intraductal iodinated contrast from the galactogram. The retained intraductal contrast obscured the area of concern on the CEM and limited evaluation for underlying areas of enhancement. Given the increasing popularity of CEM in breast imaging practice and its utility in the evaluation of patients with nipple discharge, recognition of retained intraductal contrast as a source of artifact on CEM is important so that steps can be taken to prevent acquiring a limited and/or non–diagnostic CEM. We suggest several practical steps the radiologist can take when planning the diagnostic workup of patients with nipple discharge to ensure the patient will be able to successfully undergo CEM, if needed. These steps will help reduce unnecessary patient exposure to radiation and intravenous contrast and avoid a delay in diagnosis and treatment.http://www.sciencedirect.com/science/article/pii/S1930043322000383GalactogramContrast-enhanced mammographyNipple discharge |
| spellingShingle | Shao Zun Chen, MD Timothy B. Rooney, MD Matthew M. Miller, MD, PhD Persistent post-galactogram intraductal iodinated contrast detected on contrast-enhanced mammography (CEM) in a patient with nipple discharge Radiology Case Reports Galactogram Contrast-enhanced mammography Nipple discharge |
| title | Persistent post-galactogram intraductal iodinated contrast detected on contrast-enhanced mammography (CEM) in a patient with nipple discharge |
| title_full | Persistent post-galactogram intraductal iodinated contrast detected on contrast-enhanced mammography (CEM) in a patient with nipple discharge |
| title_fullStr | Persistent post-galactogram intraductal iodinated contrast detected on contrast-enhanced mammography (CEM) in a patient with nipple discharge |
| title_full_unstemmed | Persistent post-galactogram intraductal iodinated contrast detected on contrast-enhanced mammography (CEM) in a patient with nipple discharge |
| title_short | Persistent post-galactogram intraductal iodinated contrast detected on contrast-enhanced mammography (CEM) in a patient with nipple discharge |
| title_sort | persistent post galactogram intraductal iodinated contrast detected on contrast enhanced mammography cem in a patient with nipple discharge |
| topic | Galactogram Contrast-enhanced mammography Nipple discharge |
| url | http://www.sciencedirect.com/science/article/pii/S1930043322000383 |
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