Contrast enhanced digital mammography as a predictor of breast cancer in patient with pathological nipple discharge

Background Pathological nipple discharge (PND) commonly caused by benign diseases, but occasionally it signifies a major medical concern. Ultrasonography, in addition to mammography, is regarded as the standard imaging modality in the diagnosis of PND but their sensitivity in some cases are low, subsequently we used a contrast enhanced mammography (CEDM) as supplementary diagnostic modality in patients with PND. The purpose of our study was to investigate the diagnostic efficacy of CEDM in evaluating PND patients, added values of incorporating the CEDM in the diagnostic workup of patients with PND and to demonstrate its diagnostic significance as a predictor of malignancy in these patients as there have been few studies that have addressed the role of CEDM in the evaluation of PND. Results Forty seven patients with PND were enrolled in this prospective study and underwent CEDM. The CEDM had high specificity (83.2%) compared to the combined sonomammography (SM) (59.3%), as there was a decrease in the number of false positive cases detected by the CEDM (6 cases) compared to the combined SM (11 cases). Combined (SM) had a moderate degree of agreement (55%, P = 0.01) with the final diagnosis, whereas CEDM had a strong degree of agreement (75%, P