A 38-year-old woman presents with spontaneous unilateral bloody nipple discharge. Mammography is normal. Which investigation is most appropriate for further evaluation?

• A Breast MRI
• B Core needle biopsy of the nipple
• C Positron emission mammography
• D Ductography (galactography) ✓

Explanation

Spontaneous unilateral bloody nipple discharge is most commonly caused by an intraductal papilloma. Ductography (galactography) involves cannulating the discharging duct and injecting contrast to identify intraductal filling defects. It can localize small lesions not seen on mammography or ultrasound. Breast MRI is increasingly used but ductography remains a standard targeted evaluation for pathologic nipple discharge when initial imaging is negative.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.