Injection procedure only for mammary ductogram or galactogram
CPT4 code
Name of the Procedure:
Mammary Ductogram or Galactogram (Injection Procedure for Mammary Ducts)
Summary
A mammary ductogram, also known as a galactogram, is a specialized imaging procedure used to evaluate abnormalities in the milk ducts of the breast. By injecting a contrast material into the milk ducts, doctors can use mammography to visualize and diagnose problems such as ductal ectasia or intraductal papillomas.
Purpose
The procedure is employed to investigate nipple discharge that is spontaneous, persistent, and arises from a single duct. It helps in identifying the underlying cause and planning appropriate treatment. Common goals include diagnosing abnormalities such as blockages, growths, or lesions within the milk ducts.
Indications
- Unexplained nipple discharge (especially if bloody or from a single duct)
- Persistent ductal discharge not associated with breastfeeding
- Suspected intraductal papilloma or ductal ectasia
- Imaging abnormalities requiring further evaluation
Preparation
- No specific fasting is typically required.
- Patients may be advised to refrain from squeezing the nipple or expressing fluid for 24-48 hours before the procedure.
- Diagnostic mammograms or ultrasounds may be performed prior to the procedure to localize the duct of interest.
Procedure Description
- The patient will be seated or in a supine position.
- The area around the nipple will be cleaned and sterilized.
- A small catheter or cannula is gently inserted into the targeted milk duct at the nipple.
- Contrast medium is carefully injected through the catheter into the duct.
- Mammography images are taken to visualize the duct and identify any abnormalities.
- The catheter is removed, and the patient may be given a small dressing for any minor fluid leakage.
Duration
The procedure typically takes about 30-45 minutes.
Setting
The procedure is usually performed in a radiology department, hospital, or specialized outpatient clinic.
Personnel
- Radiologist
- Radiologic technologist or nurse
Risks and Complications
- Discomfort or pain during catheter insertion
- Allergic reactions to the contrast material (rare)
- Infection at the catheter insertion site
- Minor bleeding or bruising
Benefits
- Accurate identification of abnormal conditions within the milk ducts
- Helps in planning appropriate surgical or medical treatment
- Minimally invasive with relatively quick recovery time
Recovery
- Patients can generally return to normal activities immediately.
- Mild discomfort or tenderness at the site can be managed with over-the-counter pain relief.
- Follow-up appointments may be scheduled to discuss results and any further steps.
Alternatives
- Ultrasound of the breast ducts
- MRI of the breast
- Direct surgical exploration or biopsy
- Each alternative has its own pros and cons related to sensitivity, invasiveness, and diagnostic value.
Patient Experience
During the procedure, patients may feel slight discomfort or pressure when the catheter is inserted and contrast injected. Post-procedure, there might be some tenderness or a mild sensation of fullness in the breast which typically resolves within a few hours. Pain management includes mild analgesics, and comforting measures such as warm compresses.