{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:21:29Z","timestamp":1780327289144,"version":"3.54.1"},"reference-count":27,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T00:00:00Z","timestamp":1729036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objective: To assess the efficacy of contrast-enhanced mammography (CEM) in differentiating benign from malignant breast lesions in Asian patients with bloody nipple discharge (BND). Methods: This retrospective study included 58 women with BND (mean age: 51.7 years) who underwent standardized CEM at institutions in Taiwan and Singapore. Lesion characteristics (size, enhancement, conspicuity, shape, margins) were evaluated on CEM by blinded radiologists. Non-enhanced mammography (MMG) and ultrasound (US) within a defined timeframe were compared for diagnostic accuracy. Benign or malignant status was confirmed by biopsy or 2-year imaging follow-up. Results: Malignancy was found in 29 of 58 lesions (50.0%), with ductal carcinoma in situ (DCIS) being the most common. CEM demonstrated a 100% negative predictive value (NPV) for non-enhancing lesions. Significant predictors of malignancy on multivariate analysis include enhancing lesions of size \u2265 1.5 cm (p-value 0.025) and suspicious morphological features (irregular\/spiculated margins, irregular shape, segmental\/linear NME distribution) (p-value &lt; 0.001). CEM outperformed MMG (sensitivity: 58.6%) and US (sensitivity: 79.3%), achieving a sensitivity of 100% and the highest diagnostic accuracy at 81.3%. Additionally, a CEM size cut-off of 1.5 cm yielded a sensitivity of 73.5% and a specificity of 84.3%. Conclusions: CEM effectively differentiates benign from malignant lesions in patients with BND, improving diagnostic accuracy and potentially reducing unnecessary interventions.<\/jats:p>","DOI":"10.3390\/diagnostics14202297","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T07:58:32Z","timestamp":1729065512000},"page":"2297","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Utility of Contrast-Enhanced Mammography in the Evaluation of Bloody Nipple Discharge\u2014A Multicenter Study in the Asian Population"],"prefix":"10.3390","volume":"14","author":[{"given":"Ann-Hui Jamie","family":"Ong","sequence":"first","affiliation":[{"name":"Department of Diagnostic Imaging, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonggeng","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7561-7492","authenticated-orcid":false,"given":"Swee Tian","family":"Quek","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Premilla Gopinathan","family":"Pillay","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, National University Hospital, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herng-Sheng","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Kaoshiung Veterans General Hospital, Kaoshiung 813, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Pin","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences and Biotechnology, Fooyin University, Kaoshiung 813, Taiwan"},{"name":"Department of Radiology, Kaoshiung Veterans General Hospital, Kaohsiung 813, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/j.suc.2022.06.006","article-title":"Management of Nipple Discharge","volume":"102","author":"Vavolizza","year":"2022","journal-title":"Surg. 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