Sonographic focally thick duct of breast found in screening, why is it concerning? A report of three cases

Article type: Case Report

Authors: Boonjunwetvat, Darunee^{a; b} | Rengganis, Anggraeni Ayu^{a; c} | Manasnayakorn, Sopark^d | Vongsaisuwon, Mawin^d | Tantidolthanes, Warisa^e | Sampatanukul, Pichet^{a; c; e;}

Affiliations: [a] The Queen Sirikit Centre for Breast Cancer, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand | [b] Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand | [c] Master Degree Program in Health Development, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand | [d] Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand | [e] Department of Pathology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

Correspondence: [*] Corresponding author: Pichet Sampatanukul, The Queen Sirikit Centre for Breast Cancer, King Chulalongkorn Memorial Hospital, Rama IV Rd. 1873, Pathumwan, Bangkok, 10330, Thailand. E-mail: fmedpst@gmail.com

Abstract: We report three cases of focally thickened ductal lesions found on screening ultrasonography with fine needle aspiration (FNA)-proven benign cytology in order to demonstrate the different fates of this radiographic finding. All three patients, aged 74, 69 and 68 years old, had their first time mammography and concurrent ultrasonography. Their mammograms did not show abnormalities except a focal asymmetry in one case. The sonographic focally thick ducts were the lesions of concern and all the patients had long-term follow-up. One patient had a slightly decreased lesion size on follow-up, likely to be a non-proliferative alteration of the breast. One patient’s FNA revealed a benign papillary lesion whose ductal diameter slightly increased in size with internal echo after two years with repeat FNA demonstrating epithelial papillae consistent with intraductal papilloma. The final patient had an alteration of the imaged ductal lesion in the third year of follow-up and the final specimen after surgical wide excision that was done in the fourth year confirmed cancer. We emphasize the importance of focally thickened ductal lesions found on screening sonography and underscore their need for scrutinized characterization and long term follow-up.

Keywords: Screening breast sonographic focally thick duct

DOI: 10.3233/BD-210075

Journal: Breast Disease, vol. 41, no. 1, pp. 215-219, 2022