POSSIBILITIES OF RADIOLOGICAL RESEARCH METHODS IN THE DIAGNOSIS OF BREAST INTRADUCTAL LESIONS
Discharge from the nipples is the third most common complaint of mammologist patients with a frequency of about 7-10%. Discharge from the nipple is divided into physiological and pathological, depending on their nature and a number of other characteristics. Most nipple discharge is due to benign disease, but malignant changes such as papillary carcinoma, ductal carcinoma in situ (DCIS), or invasive ductal carcinoma are common. Patients with abnormal discharge require radiology examination, regardless of age. Purpose of the study. To study the possibilities of radiological research methods in the diagnosis of breast intraductal. Materials and methods. From November 2019 to May 2021, 40 patients with pathological nipple discharge underwent an X-ray examination, which consisted of digital ductography using digital tomosynthesis and ultrasound of the mammary glands with a targeted examination of the periareolar zone from the side of interest. This study included 37 women ( mean age 45.2 years; range 28-62 years). Results. All patients with a positive result of ductography and/or ultrasound were recommended and underwent morphological verification: in 9.1% (3/33) of cases, trephine biopsy, according to which a papilloma was detected, followed by surgical excision. In all 3 cases, the pathomorphological conclusion of the trepanobiopsy and postoperative material coincided with the data of visual diagnostics. In 15.2% (5/33) of cases - malignant intraductal lesions, in 84.8% (28/33) of cases, the results of histology were benign: 64.3% (18/28) of them were verified solitary central papillomas, 32, 1% (9/28) of cases of papillomatosis, and 3.6% (1/28) of high risk lesions - papilloma with atypia. Malignant tumors were distributed as follows: 80% (4/5) ductal carcinomas in situ and 20% (1/5) microinvasive carcinomas. Conclusions. Thus, ductography is a reliable and widely available diagnostic tool in women with abnormal nipple discharge, potentially avoiding unnecessary MRI for some patients