Galactography acquired with digital mammography in patients with nipple discharge: A retrospective analysis

Department of Radiology, Kang-Nam St Mary's Hospital, Catholic University of Medical College, Seoul, South Korea.
Archives of Gynecology (Impact Factor: 1.36). 08/2009; 280(2):217-22. DOI: 10.1007/s00404-008-0897-8
Source: PubMed


To evaluate the galactographic findings taken with digital mammography and to compare the findings between benign and malignant breast diseases.
Galactographic findings were retrospectively analyzed and compared with histopathological results for 42 patients who showed abnormal findings on galactography and had histologically proven diagnoses between January 2005 and March 2008. A galactography was acquired using full-field digital mammography (Hologic Lorad Selenia; Danbury, USA). The difference in galactographic findings between malignant and benign breast diseases was analyzed using chi(2) test. A value of P < 0.05 was considered statistically significant.
Of the total 42 cases, 11 cases were malignant breast diseases and 31 were benign diseases. Common galactographic findings of benign diseases include ductal obstruction (48.3%) and single filling defect (51.6%), and common findings for malignant tumor include ductal dilatation (72.7%) and stenosis (63.6%). Ductal stenosis, microcalcifications or mass adjacent to abnormal duct, multiple filling defects, ductal wall irregularity, ductal distortion and irregular filling defects were more prevalently seen in malignant cases. A single filling defect and lobular filling defect was more prevalently seen in benign cases (P < 0.05). Ductal dilatation was a common finding in both malignant and benign cases with no significant difference.
Ductal lesions were well visualized on galactography acquired with a digital mammography. A preoperative diagnostic galactography is useful in making a differential diagnosis between benign diseases and malignant tumors in patients with pathologic nipple discharge.

13 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Galactography is the technique of choice for investigating pathological nipple discharge. However, there is no standardized interpretation system for this procedure. To evaluate radiological and histological correlation using a Galactogram Imaging Classification System (GICS). Material and Methods: We retrospectively studied all galactograms obtained in 62 women with pathological nipple discharge who subsequently had biopsy at our institution between 1999 and 2007. The GICS proposes five categories for galactographic findings: GICS 1: negative; GICS 2: benign; GICS 3: probably benign; GICS 4: suspect for malignancy; GICS 5: highly suspect for malignancy. The galactographic findings were classified as follows: GICS 2: 25.8% (16/62); GICS 3: 30.6% (19/62); GICS 4: 25.8% (16/62); and GICS 5: 17.7% (11/62). A good correlation was observed between histological diagnosis and GICS categories (P < 0.05). All the cases diagnosed with carcinoma (n = 11) were classified in GICS category 5. The present study shows a good correlation between GICS categories and histological diagnosis.
    Acta Radiologica 12/2009; 51(2):128-36. DOI:10.3109/02841850903436659 · 1.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A new system for the classification of galactograms is reported. To date, there is no universally accepted classification system. To evaluate inter- and intra-observer agreement of the Galactogram Imaging Classification System (GICS) MATERIAL AND METHODS: Six observers with different levels of experience retrospectively evaluated 30 galactograms using the GICS. Images were reviewed independently twice within a four-week period. The kappa statistic was calculated for intra- and inter-observer variability. The kappa for inter-observer agreement was moderate to substantial (range 0.41-0.72). Overall, the intra-observer kappa values were excellent (range 0.80-0.94). The present study shows a good to very good inter- and intra-observer agreement with the GICS. We believe the GICS can be incorporated into daily practice.
    Acta Radiologica 07/2011; 52(8):829-33. DOI:10.1258/ar.2011.110118 · 1.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to evaluate the usefulness of galactography (GL) in the early diagnosis of breast cancer in patients with pathologic nipple discharge (PND). We retrospectively studied all galactograms obtained in 117 women with PND, who subsequently had a biopsy. The findings detected in the galactograms of the patients in this study were assigned to different categories of the Galactogram Image Classification System (GICS): GICS 2, benign; GICS 3, probably benign; GICS 4, suspicious for malignancy; and GICS 5, highly suspicious for malignancy. The galactograms were classified into GICS 2 (29 cases; 24.7%), GICS 3 (42 cases; 35.8%), GICS 4 (30 cases; 25.6%), and GICS 5 (16 cases; 13.6%). A good correlation was observed between histological diagnosis and GICS categories (p < 0.05). All cases diagnosed with carcinoma (n = 18) were classified in GICS categories 4-5: ductal carcinoma in situ in 14 cases (11.9%) and invasive carcinoma in 4 cases (3.4%). GL is a useful procedure in the early diagnosis of breast cancer in patients with PND.
    Breast Care 05/2013; 8(2):122-6. DOI:10.1159/000350779 · 0.63 Impact Factor