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Breast Ductography

Last updated April 28, 2017

U.S. Navy

Breast Ductography (Galactography) procedure is an X-ray examination that uses mammography to examine the breast and produce images of the milk ducts located inside breasts, called galactograms.


Background Information:

What are the other Names for the Procedure?

  • Contrast Mammography
  • Ductogalactography
  • Ductogram/Galactogram

What is Breast Ductography radiology procedure? (General Explanation)

  • Breast Ductography (Galactography) procedure is an X-ray examination that uses mammography to examine the breast and produce images of the milk ducts located inside breasts, called galactograms
  • Ultrasounds, mammography, and MRI scans are good imaging tools for the breasts; though, they are not suitable for obtaining images of the breast milk ducts. Galactography is an important radiological tool that helps in obtaining such image types

What part of the Body does the Procedure involve?

A Breast Ductography procedure involves the women’s breast.

Why is the Breast Ductography radiology procedure Performed?

  • A Breast Ductography procedure is used to evaluate women with bloody or clear discharge from the breast nipples, but having a normal mammogram
  • This procedure is not used on women, who have not had any children previously
  • It is used when women are having discharge from both breasts. In such cases, it may mostly indicate the side effects of a drug, or may be related to a pituitary problem
  • A green, yellow, black, gray, or milky discharge is usually not abnormal and does not need an exam

What is the Equipment used? (Description of Equipment)

The equipment for a Breast Ductography (Galactography) consists of:

  • A rectangular box, which produces X-rays
  • The box is attached to a device that can hold and position the breast, so that the images may be obtained from different angles
  • By this device, only the breasts are exposed to X-rays

What are the Recent Advances in the Procedure?

There have been no recent advances with respect to the Galactography (Breast Ductography) procedure.

What is the Cost of performing the Breast Ductography radiology procedure?

The cost of the Breast Ductography procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding a Breast Ductography procedure and what needs to be done.
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician.
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=galactogram (accessed on August 2, 2014)

Prior to Breast Ductography radiology Procedure:

How does the Breast Ductography radiology procedure work?

  • X-rays produced by a device pass through the breasts and produces images on a recording plate
  • In Breast Ductography, a contrast material is injected into the milk ducts and a mammogram is done, to check the inside of the milk ducts
  • If there is a darkened/black area in the milk duct, it may indicate a small mass. Most of such masses are benign and may be easily removed
  • If there is a cyst present in the breast, it may cause a bloody discharge. Though, it may not pose any serious problem

How is the Breast Ductography radiology procedure Performed?

A Breast Ductography procedure may be performed as follows:

  • The patient is positioned on the examination table on the their back, exposing the breasts
  • The nipple is cleaned and squeezed, to see if the duct is discharging fluid
  • After identifying the right duct, it is dilated and a catheter inserted
  • The contrast material is injected into the milk duct and a mammogram is performed as below:
    • The breasts are positioned on a platform and gradually compressed. Even small abnormalities are visualized and only a low dose of X-ray is needed
    • The patient is asked to stay still during the imaging process, to prevent blurring of the image
    • The patient may be asked to change their positions, to obtain images from different angles

Where is the Procedure Performed?

A Breast Ductography procedure is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

A Breast Ductography procedure is usually performed by a radiology technologist, under the supervision of a radiologist.

How long will the Procedure take?

The Breast Ductography procedure takes about 30 minutes to an hour to complete.

Who interprets the Result?

  • The radiologist interprets the results of a Breast Ductography procedure and informs the primary care physician, who then informs the patient
  • The patient may be asked to have a follow-up exam, if there is a suspicious finding that needs clarification, or to see the progress of a treatment

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Breast Ductography procedure:

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
  • Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
  • Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
  • It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
  • Women should notify the physician, if they are pregnant or breastfeeding their child; as many such procedures may not be performed on pregnant women
  • The patient may be asked to avoid eating or drinking, several hours before the test
  • Patients are advised not to squeeze the nipple before an exam, to see the origin of the fluid
  • Patients should not apply any talcum powder, lotion, or deodorant under their arms, during the exam, as these may show up as calcium spots on a mammogram and give erroneous results

What is the Consent Process before the Procedure?

A physician will request your consent for the Breast Ductography procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of a Breast Ductography procedure:

  • The procedure can identify even small masses and the location of those masses for surgery
  • Radiation from the procedure does not remain in the patient’s body and there are no side effects

Following are the risks of a Breast Ductography procedure:

  • Catheter insertion may injure the milk duct, but it does not cause any serious problem
  • There is a slight chance of a breast infection
  • There is a very minimal chance of getting cancer, from exposure to radiation
  • There is a possibility of false positive mammograms, where the tests are positive even though there is no cancer risk. In such cases, the patients may have to go through additional imaging or biopsies, to confirm that there is no cancer
  • It is highly recommended that women inform their physician, if they are pregnant

What are the Limitations of the Breast Ductography radiology procedure?

Following are the limitations of a Breast Ductography procedure:

  • Some milk ducts are small and hard to dilate; it is difficult to insert a catheter in them
  • The catheter insertion must be very precise; otherwise the insertion in a wrong duct may give false results
  • If the nipples were squeezed before the exam, or there is no discharge at the time of exam, the proper duct cannot be identified. In such cases, the test cannot be performed
  • Talcum powder or deodorant on the breast may produce false positive results
  • It may be hard to obtain an accurate mammogram, if the patient has implants, such as silicon and saline implants. These may block the view of breast tissues behind them
  • In case of breast implants, the patient should inform the doctor or the radiation technologist in advance about such implants, for accurate mammograms

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

  • What is the Breast Ductography (Galactography) procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Is there any medication that needs to be taken for life, after the procedure?
  • What are the costs involved?

During the Breast Ductography radiology procedure: 

What is to be expected during the Breast Ductography radiology procedure?

The following may be expected during a Breast Ductography (Galactography) procedure:

  • The patient will feel pressure on the breasts, when they are compressed on the device
  • There may be some discomfort
  • In case of pain, the patient should notify the technologist to use less compression on the breasts

What kind of Anesthesia is given, during the Procedure?

No anesthesia is administered during the Breast Ductography (Galactography) procedure.

How much Blood will you lose, during the Procedure?

There is generally no blood loss involved in a Breast Ductography (Galactography) procedure.

What are the possible Risks and Complications during the Breast Ductography radiology procedure?

The possible risks of Breast Ductography procedure include:

  • The catheter insertion may injure the milk duct, but it does not cause any serious problem
  • There is a slight chance of breast infection
  • There is a very minimal chance of getting cancer from exposure to radiation
  • False positive mammogram results are possible; even though there is no risk of cancer. In such cases, the patients may have to go through additional tests, to confirm that there is no cancer present

What Post-Operative Care is needed at the Healthcare Facility after the Breast Ductography radiology procedure?

  • There is no postoperative care necessary after a Galactography procedure
  • However, if the patient experiences lingering pain due to the catheter insertion, then they should notify the physician immediately

After the Breast Ductography radiology procedure: 

What is to be expected after the Breast Ductography radiology procedure?

The patient may resume their normal activities immediately after the Breast Ductography procedure, unless instructed otherwise by the radiation technologist or their physicians.

When do you need to call your Physician?

If the patient is experiencing discomfort after a Breast Ductography procedure, then they should contact the physician.

What Post-Operative Care is needed at Home after the Breast Ductography radiology procedure?

No specific post-operative care is needed at home after the Breast Ductography procedure.

How long does it normally take to fully recover, from the Procedure?

The patient may resume their normal activities, immediately after the Breast Ductography procedure, unless informed otherwise.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue is extracted from the patient during a Breast Ductography procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Breast Ductography radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • A radiologist, performing the procedure
  • Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Breast Ductography (Galactography) procedure is performed. 

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 30, 2014
Last updated: April 28, 2017

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