Ductography

What is Galactography? Galactography, or ductography, is a mammographic technique that involves injection of a contrast agent (dye) into a milk duct. This study may be useful in the evaluation of unilateral spontaneous nipple discharge that is bloody. (Nipple discharge that is milky, yellow, or green is rarely associated with breast cancers.) What can I expect from the examination? The initial radiologic evaluation of nipple discharge includes a mammogram. If no abnormality is visible, a galactogram may be indicated. The duct must be discharging on the day of the study in order to identify the correct orifice to be cannulated. A tiny blunt-tipped catheter (called a cannula) is inserted into the discharging duct and a small (approximately 1 ml) amount of contrast agent is injected. Additional mammographic images are obtained. Some patients report a sensation of "fullness" during the examination, but no sharp pain or burning should be experienced. If an abnormality is detected on the galactogram, surgical excision is recommended. The most common cause of abnormal nipple discharge is a papilloma (a benign tumor that grows from the wall of a duct). Fewer than 10% of patients with abnormal duct discharge have a related breast malignancy.

The figure to the left is a galactogram. Note that the contrast material dramatically increases the visibility of the ducts.