Galactography acquired with digital mammography in patients with nipple discharge: a retrospective analysis.
ABSTRACT 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.
Article: Ductography: how to and what if?[show abstract] [hide abstract]
ABSTRACT: Ductography of the breast is an underused procedure that often helps define the cause of unilateral, single-pore, spontaneous nipple discharge. Since nipple discharge may be caused by benign tumors, such as papillomas, or by carcinoma, such as ductal carcinoma in situ, identification of intraductal abnormalities with ductography is important. Further, diagnostic ductography and preoperative ductography help guide accurate surgical intervention. Without prior ductography, central duct excision may not result in removal of the abnormal ductal tissue or may result in removal of only a portion of the abnormal ductal system, causing the extent of disease to be effectively understaged. Once fundamental ductographic principles are learned, the procedure is easy to perform. If extravasation occurs, ductography is rescheduled for 7-14 days later. Elimination of air bubbles from the cannula, syringe, and extension tubing is vital. When reflux occurs, radiologists must be aware of a possible tumor in the distal-most duct. When ductal ectasia or fibrocystic changes are the cause of the discharge, conservative follow-up may be considered. Diagnostic radiologists who learn the technique of ductography and include it in their evaluation of nipple discharge will improve their interdisciplinary approach to this important sign of breast cancer.Radiographics 21(1):133-50. · 2.79 Impact Factor
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ABSTRACT: To evaluate preoperative galactographic findings in the differentiation between the benign and malignant lesions in patients presenting spontaneous nipple discharge without mass. Of the 215 patients who have undergone the galactography, 181 cases with abnormal galactography had surgery performed. All galactrograms were reviewed and galactographic findings were correlated to the pathological results to determine diagnostic differentiation. Of the 181 cases we operated on, 112 cases were macroscopically bloody, with 30 cases having cancers (26.8%). Fifty-four cases with serous discharge had seven cancer cases (13.0%). No cancer cases with other color discharge were found. Of the 37 cancer cases, 11 cases had lesions located in the main mammary ducts (lactiferous duct and the segmental duct) (29.7%) and 26 cases had lesions in the peripheral ducts (the subsegmental duct and its branches) (70.3%) (P<.05). Of 113 cases with benign proliferative ductal lesions, 88 cases were located in the main mammary duct (77.9%) and 25 cases in the peripheral mammary duct (22.1%) (P<.05). Otherwise, 29 cancer cases (82.9%) had ductal obstructions and 28 cancer cases (75.7%) had irregular intraductal defects that appeared in the galactograms, which is different from the 113 benign proliferative ductal lesion cases that had 88 cases (71.7%) with ductal dilatation and 90 cases (79.6%) with lobular or smooth intraductal defects (P<.05). These results showed that the cancer cases had a higher rate of locating in the peripheral duct, irregular intraductal duct defects, and ductal obstruction, and a lower rate associated with ductal dilatation or torsion. The galactographic findings were evaluated using the tumor location, types of intraductal defects, ductal obstruction, and dilatation. Preoperative diagnostic galactography is useful in differentiating between the benign or malignant lesions in patients with spontaneous nipple discharge.Clinical Imaging 01/2001; 25(2):75-81. · 0.65 Impact Factor
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ABSTRACT: Ductography has become the gold standard for the evaluation of patients exhibiting pathologic nipple discharges. In nine patients (age range, 29-67 years; median age, 51 years) with invasive (n=5) or intraductal (n=4) cancer, ductographic findings were recorded, then correlated with mammographic and sonographic findings. Common ductographic findings included complete ductal obstruction, multiple irregular filling defects in the nondilated peripheral ducts, ductal wall irregularities, periductal contrast extravasation, and ductal displacement. Faint microcalcifications or ill-defined masses, which were not opacified by contrast material, were often discovered adjacent to ductal abnormalities. Mammographically and sonographically occult diffusely spreading intraductal cancers often manifested as pathologic nipple discharge. In such cases, meticulous ductographic examinations and interpretations were crucial in order not to miss breast cancers.Korean Journal of Radiology 6(1):31-6. · 1.56 Impact Factor