Name of the Procedure:

Mammary Ductogram (Galactogram)

Summary

A Mammary Ductogram, also called a Galactogram, is a specialized x-ray procedure used to investigate abnormalities within a single milk duct of the breast. It's commonly performed when there's nipple discharge to determine the underlying cause.

Purpose

The procedure aims to identify abnormalities like intraductal papillomas, ductal carcinoma in situ (DCIS), or other lesions within the milk ducts that might be causing nipple discharge. By pinpointing the exact nature and location of these abnormalities, appropriate treatment can be planned.

Indications

• Unexplained nipple discharge, particularly if it's bloody or clear.
• Suspected intraductal lesions noted in physical exams or other imaging studies.
• Persistent nipple discharge unresponsive to other interventions.

Preparation

• No special preparation like fasting is typically required.
• Patients should inform the healthcare provider of any allergies, particularly to contrast dyes or iodine.
• Patients may be advised to avoid applying lotions, powders, or deodorants to the breast area on the day of the procedure.

Procedure Description

1. The patient is positioned comfortably, and the nipple and areola are cleaned.
2. A tiny, flexible catheter is gently inserted into the duct opening at the nipple.
3. Contrast dye is injected through the catheter into the duct.
4. X-ray images (mammograms) are taken to visualize the duct and any abnormalities.
5. The catheter is removed, and the breast is cleaned.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Mammary ductograms are usually performed in a hospital radiology department or an outpatient imaging clinic.

Personnel

• Radiologist (physician specializing in medical imaging)
• Radiologic technologist or nurse

Risks and Complications

• Mild discomfort or pain during catheter insertion.
• Risk of infection at the insertion site.
• Allergic reaction to the contrast dye.
• In rare cases, duct perforation may occur.

Benefits

• Helps in the precise diagnosis of the cause of nipple discharge.
• Non-invasive with minimal discomfort.
• Can guide further treatments and interventions.

Recovery

• Patients can typically return to normal activities immediately after the procedure.
• Mild soreness may be felt at the nipple but should resolve quickly.
• Follow-up imaging or testing might be scheduled based on the results.

Alternatives

• Breast ultrasound: Non-invasive but may not provide as detailed information about intraductal structures.
• MRI: More detailed imaging but more expensive and not always necessary.
• Regular mammography: May not detect duct-specific issues.

Patient Experience

• Patients might feel slight discomfort or pressure during the injection of the contrast dye.
• Any discomfort post-procedure is usually minimal and temporary.
• Over-the-counter pain relievers can be used if necessary, but most patients don’t require them.
• The radiology team will ensure comfort and answer any questions throughout the process.