50-year-old woman with clear left nipple discharge (benign papilloma)
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So our first case is a 50-year-old
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woman with clear left nipple discharge.
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So for this patient, we have CC views
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at the top of our screen and MLO
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views at the bottom of the screen.
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And her discharge was on the left and was clear.
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And we can see this duct or, you know, kind of
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branching duct behind the nipple on the CC view.
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And then you see that sort of
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single duct on the MLO view.
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She had had a prior biopsy of something near
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this, but it wasn't exactly in the same place.
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You can see that ribbon-shaped biopsy clip here.
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So we'll look at these
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images a little more closely.
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17 00:00:42,405 --> 00:00:46,185 This is the left, uh, CC view, and we'll go
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through our tomosynthesis images as well.
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We can see that large duct very nicely
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shown with the tomosynthesis images
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with several branches coming off of it.
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And then we can see that clip,
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which is, uh, separate from the duct.
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So that's the CC.
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Here's our MLO view and our tomosynthesis images.
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And you can see as we're scrolling through,
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we can see that clip, and then we have this,
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you know, large duct centrally, and then branching,
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and really nothing else going on in that breast.
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In a lot of cases, this may be the, um,
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our chance to screen the opposite breast,
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so we always want to make sure that we're
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taking a good look at the other breast.
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So, this is the right CC view and
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right CC tomosynthesis images showing
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some benign calcifications and a
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little intramammary lymph node there
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laterally, otherwise nothing suspicious.
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Look at the right MLO view
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and the MLO tomosynthesis images
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showing some normal-looking lymph nodes.
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Normal-looking intramammary lymph
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node, but nothing suspicious there.
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So our next step for this
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patient will be, um, ultrasound.
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So we did the ultrasound, and basically
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we see this big duct with, um,
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a mass inside it with some blood flow.
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Actually, some nice images, uh, from the
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day she came in for biopsy showing that
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large duct, and, uh, mass within the, uh,
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duct, and some blood flow within the mass.
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So, um, in this case, we went ahead
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and recommended ultrasound-guided
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biopsy since we could see it that way.
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And, um, this turned out to be a benign papilloma.
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
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