Galactography or ductography (or ''galactogram'', ''ductogram'') is a medical diagnostic procedure for viewing the

milk ducts Lactiferous ducts are ducts that converge and form a branched system connecting the nipple to the lobules of the mammary gland. When lactogenesis occurs, under the influence of hormones, the milk is moved to the nipple by the action of smooth mus ...

. The procedure involves the

radiography Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography ("diagnostic" and "therapeut ...

of the ducts after injection of a radiopaque substance into the duct system through the nipple. The procedure is used for investigating the pathology of

nipple discharge Nipple discharge is fluid from the nipple, with or without squeezing the breast. The discharge can be milky, clear, green, purulent, bloody, or faintly yellow. The consistency can be thick, thin, sticky, or watery. Nipple discharge may be norma ...

. Galactography is capable of detecting smaller abnormalities than

mammogram Mammography (also called mastography) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through d ...

MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...

ultrasound Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...

tests. With galactography, a larger part of the ductal system can be visualized than with the endoscopic investigation of a duct (called galactoscopy or

ductoscopy Ductoscopy or mammary ductoscopy (also: ''breast duct endoscopy'', ''galactoscopy'') is a medical diagnostic procedure for viewing and collecting epithelial cells and other internal features of the milk ducts. It is capable of detecting smaller abn ...

). Causes for nipple discharge include

duct ectasia Duct ectasia of the breast, mammary duct ectasia or plasma cell mastitis is a condition that occurs when a milk duct beneath the nipple widens, the duct walls thicken, and the duct fills with fluid. This is the most common cause of greenish dischar ...

intraductal papilloma Intraductal papillomas of the breast are benign lesions with an incidence of approximately 2-3% in humans. They result from abnormal proliferation of the epithelial cells lining the breast ducts. Two types of intraductal papillomas are generally ...

, and occasionally

ductal carcinoma in situ Ductal carcinoma in situ (DCIS), also known as intraductal carcinoma, is a pre-cancerous or non-invasive cancerous lesion of the breast. DCIS is classified as Stage 0. It rarely produces symptoms or a breast lump one can feel, typically being d ...

invasive ductal carcinoma Invasive carcinoma of no special type (NST) also known as invasive ductal carcinoma or ductal NOS and previously known as invasive ductal carcinoma, not otherwise specified (NOS) is a group of breast cancers that do not have the "specific different ...

. The standard treatment of galactographically suspicious breast lesions is to perform a surgical intervention on the concerned duct or ducts: if the discharge clearly stems from a single duct, then the excision of the duct (

microdochectomy Microdochectomy is the surgical removal (excision) of a lactiferous duct. A mere incision of a mammary duct (without excision) is called ''microdochotomy''. Indication Microdochectomy is a standard treatment of in case there is nipple discharge w ...

) is indicated; if the discharge comes from several ducts or if no specific duct could be determined, then a subareolar resection of the ducts (

Hadfield's procedure Central duct excision is the surgical removal (excision) of all lactiferous duct under the nipple. The excision of a single duct is called microdochectomy, a mere incision of a mammary duct (without excision) is ''microdochotomy''. Indication Ce ...

) is performed instead. To avoid infection, galactography should not be performed when the nipple discharge contains

pus Pus is an exudate, typically white-yellow, yellow, or yellow-brown, formed at the site of inflammation during bacterial or fungal infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection ...

References

{{Medical imaging Projectional radiography Breast imaging Cancer screening

See also

References