We are exploring breast discharge this week, and while the imaging evaluation may include routine things like mammography, breast ultrasound or breast MRI, there is a special imaging procedure called a ductogram that may also be requested. What is ductography? Also known as galactography, it is a way of imaging the ducts of the breast.
Imaging evaluation for this problem will usually start with mammography and/or breast ultrasound. A ductogram is most useful for cases of discharge when it is arising from only one side. The aim is to evaluate the duct that is leaking the fluid, so being able to see the discharge from the nipple is important.
A ductogram is performed using mammograms to image the duct after the duct is highlighted by injection with a tiny amount of contrast material (also sometimes called dye, although the fluid is clear!). The radiologist will start by determining which duct is responsible for the discharge by trying to express fluid. A blunt-ended tiny catheter is placed in the duct. A tiny amount of contrast material is injected. The breast is then imaged using mammograms in one or more views. More contrast may need to be given and will be tailored based on what the initial images show.
Preparation for the ductogram is the same as for a mammogram - no lotions, talcum powder or antiperspirants should be used on the skin before the exam. These can leave “artifacts” or small flecks on the images which can be confused for other things. The experience of the ductogram is similar to that of a mammogram, with the exception of the injection of contrast which may cause a sensation of pressure or fullness in the breast. The images are obtained with compression of the breast just as with a regular mammogram.
The images will be interpreted by the radiologist in conjunction with any other breast imaging studies you have had. For more great information on this subject, we recommend radiologyinfo.org’s page on galactography.
So, if you experience leakage from a breast either milky, bloody or any substance that is new, you should contact your healthcare provider. Let them evaluate you and decide if breast imaging is indicated. If a ductogram or ductography is ordered you will now know what to expect.
Originally published 1/2//14 on mammographykc.com.