Ductography / Galactography

A ductogram is a mammographic procedure that is performed to help identify an abnormality in the breast duct that may be the source of nipple discharge and is valuable in diagnosing intraductal papillomas and other conditions. Papillomas are wart-like, non-cancerous tumors with branchings or stalks that have grown inside the breast duct; they are the most common cause of nipple discharge.

 

Nipple discharge can be caused by non-cancerous tumors such as papillomas, or cancer such as ductal carcinoma in situ (DCIS). However, the majority of nipple discharges are due to benign (non-cancerous) causes. In particular, discharges that are yellow, green, blue or black in color are usually categorized as less suspicious. Discharges that are bloody, colorless or clear in color are categorized as more suspicious, but further investigation usually results in a benign diagnosis. Bilateral nipple discharge (discharge occurring from both breasts) is usually benign and does not typically require investigation with ductography or other procedures. However, all persistent discharges should be reported to a physician for evaluation.

 

Ductography is performed on women who have a spontaneous nipple discharge. A blunt cannula is inserted into the ductal opening of the nipple producing the spontaneous discharge. A contrast media is injected into this duct, and mammography images are taken to show the duct in question. The ductogram may or may not identify the cause of the nipple discharge. The majority of patients who undergo ductography ultimately need surgery to treat the discharge. Surgery may involve removing a papilloma or, in some cases, removal of the entire ductal system may be required.

 

Some surgeons feel that ductography is unnecessary since the patient will likely need surgery anyway. However, identifying the type of abnormality, locations of the abnormalities and number of abnormalities, and their extent in the breast can be very helpful in aiding the surgeon in either removing as little tissue as necessary or in making sure to remove all the involved tissue associated with extensive abnormalities.