Duct ectasia with inspissated secretions
A 65 year old female presents with a tubular density in the subareolar right breast on mammogram
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The ultrasound images confirm duct ectasia of the right breast. The ducts contain echogenic material with no flow on Doppler imaging. The diagnosis is inspissated secretions in the duct and no further management is indicated. The Doppler images are key to differentiate this condition from a papilloma: the papilloma should show some blood flow on Doppler.
The inspissated secretions do not have to extend in a sausage-like fashion along the duct; they can be focal and quite difficult to distinguish from a papilloma. Pay attention to the Doppler images.