Intraductal Filling Defect

IMAGING FINDINGS:​
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Spot compression tomosynthesis view demonstrates a tubular hyperdense mass that appears contiguous with a duct. Breast ultrasound shows an oval heterogenous circumscribed mass within a duct.
 
WHY IT MATTERS:

1. Intraductal masses or filling defects are commonly seen in the workup of nipple discharge.
2. Assessing for “blood flow” with Doppler ultrasound can be helpful to distinguish a true mass from debris.
3. The differential diagnosis for an intraductal mass on ultrasound includes 

                         a. Papillary (papilloma or papillary DCIS)
                         b. Invasive ductal carcinoma
                         c. Ductal debris (not a true mass)
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FURTHER READING:
Intraductal Mass on Breast Ultrasound: Final Outcomes and Predictors of Malignancy (AJR, 2013)