Ductogram (Galactogram)

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A (galactogram) is a procedure that uses mammography along with the injection of contrast material into the nipple to visualize the breast’s milk ducts. This non-invasive procedure is helpful when the patient has nipple discharge but has an otherwise normal mammogram.  Ductograms are performed in the mammography room by an  interventional radiologist and is an out-patient procedure. Ductograms are helpful in determining the cause of nipple discharge and diagnosing ductal ecstasia (swollen/clogged milk ducts), fibrocystic changes, interductal papillomas (wart-like, non-cancerous tumors that grow inside the duct) and breast cancer.

 

Need to Know

Nice to Know
  • If you take blood thinners, talk to your doctor beforehand about adjusting or stopping this medication
  • Wear comfortable loose clothing and wear/bring a supportive sports bra
  • Do not wear any powders, deodorant or lotion on the day of the procedure
  • Allow about one hour for your procedure – this includes the pre and post procedure care
  • Always inform the staff if you think you may be pregnant
  • Inform us of any previous contrast reactions or any allergies to latex or Lidocaine
  • You will receive post procedure instructions including what to do if you experience swelling and bruising following your biopsy or experience discomfort not resolved with non-aspirin pain relief
  • The majority of patients who undergo ductography will need surgery to remove a papilloma or nodule in the breast duct.
  • The ductogram procedure takes between 30 minutes to an hour
  • Contrast reaction is rare
  • Dilation of ducts may be uncomfortable; however it is not usually painful
  • Most nipple discharge is non-cancerous
  • Discharge that is yellow, green, blue or black in color is usually categorized as less suspicious than bloody, colorless or clear discharge
  • Discharge from both breasts in women who have not had children may indicate a side effect from a drug, or may be related to a pituitary problem in the brain
  • Use a non-aspirin pain reliever such as acetaminophen (Tylenol) or ibuprofen (Motrin-Aleve) for any post procedure discomfort

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Why is This Exam Done?

Nipple discharge is a symptomatic problem that causes many women discomfort and anxiety. Mammography, ultrasound and MRI all image the breast but cannot demonstrate the details of the breast ducts as this contrast enhanced study can. The procedure is performed while you are experiencing nipple discharge so the radiologist can locate the specific duct that is leaking.

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What Will Happen During the Exam?

  • You will be asked to remove all clothing from the waist up and change into a gown
  • Warm towels will be placed on your breast to allow easier access to the milk duct
  • You will be positioned in a reclining chair and your nipple will be cleansed
  • The radiologist will use a lighted magnification tool to visualize the nipple area
  • The radiologist will apply pressure to the nipple to begin fluid discharge to  locate the source or trigger zone.
  • A small hollow needle is inserted into the nipple and gently guided to dilate the duct
  • The tube will be taped in place and connected to a syringe filled with a contrast agent
  • A small amount of contrast will be slowly injected  through the needle
  • A lightly compressed mammography image will be performed
  • The radiologist will review the images in the examination room
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How Should I Prepare?

  • You may eat, drink and perform normal daily activities prior to this procedure
  • Do not squeeze the nipple prior to the exam as it is important for the radiologist to see where the fluid is coming from
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What Are the Benefits and Risks?

The benefits of Breast Biopsy (Fine Needle Aspiration):

  • Ductography can locate small cancerous and non-cancerous masses that cannot be identified with other breast imaging exams.
  • Identifies the location of tumors in the breast for surgeons so they can be removed at an early stage

Risks you should be aware of:

  • Complications: Extravasation – flow of contrast media from the breast duct to surrounding tissue which is treated with acetaminophen (Tylenol) or ibuprofen (Motrin-Aleve)
  • Infection of the breast (mastitis) – uncommon, but always a risk where the skin is penetrated
  • Test Reschedule - The radiologist performing the test needs to see the discharge to determine which milk duct is producing it
  • Duct may not dilate adequately to allow injection of contrast
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Where Can I Get This Exam?

We perform breast biopsies in our Farmington office.

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