Journal of Ultrasound in Medicine, Vol 16, Issue 3 161-168, Copyright © 1997 by American Institute of Ultrasound in Medicine
Sonographic features of benign papillary neoplasms of the breast: review of 22 patients
W. T. Yang, M. Suen and C. Metreweli
Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong.
The sonographic features of 22 patients with histologically benign
intraductal papillomas are presented, with clinical, mammographic,
galactographic, and histopathologic correlation. The most common presenting
feature in this series is a palpable central breast mass in an elderly
woman. Sonography was abnormal in all 22 patients. The typical sonographic
features include a well-defined, smooth-walled, solid, hypoechoic nodule or
a lobulated, smooth-walled, cystic lesion with solid components. Dilated
ducts are a common feature, often with visible solid intraluminal echoes.
These findings suggest the diagnosis of an intraductal papilloma. The
differential diagnosis includes fibroadenoma and phyllodes tumor (for large
solid lesions) and intracystic carcinoma (for complex cystic lesions).
Mammograms are frequently normal (36% of patients). When abnormal, the
mammographic features are of a smooth-walled, well-defined mass or
increased retroareolar opacity. Contrary to the reported literature,
calcification was seen infrequently. We conclude that ultrasonography is
useful in the detection and delineation of intraductal papillomas.