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Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation

CPT4 code

Name of the Procedure:

Mammary Ductogram or Galactogram (Radiological Supervision and Interpretation, Multiple Ducts)

Summary

A mammary ductogram, also known as a galactogram, is an imaging procedure used to visualize the milk ducts within the breast. This is done using a special dye and X-ray technology to identify blockages, abnormalities, or other issues affecting the ducts.

Purpose

This procedure is designed to diagnose and assess conditions related to abnormal discharge from the nipples, breast ductal abnormalities, and to identify potentially cancerous growths within the milk ducts.

Indications

  • Unusual or bloody nipple discharge
  • Suspected intraductal papilloma or ductal carcinoma
  • Persistent breast pain localized to the nipple area
  • Abnormal findings in other breast imaging studies

Preparation

  • Patients may be advised to avoid using lotions, powders, or deodorants on the day of the procedure.
  • Inform your doctor of any medications or allergy history, especially concerning contrast materials.
  • A baseline mammogram might be performed prior to the ductogram.

Procedure Description

  1. The patient lies on their back or sits upright.
  2. The nipple is cleaned, and a fine tube (cannula) is gently inserted into the duct opening on the nipple.
  3. A small amount of contrast dye is injected through the tube into the milk ducts.
  4. X-ray images are taken to capture detailed views of the ducts.
  5. The radiologist interprets the images to identify any abnormalities.

Tools and equipment used: X-ray machine, cannula, contrast dye. No anesthesia is typically required, but local anesthesia may be used if needed.

Duration

The procedure generally takes about 30 minutes to 1 hour.

Setting

Performed in a radiology department within a hospital or an outpatient imaging center.

Personnel

  • Radiologist
  • Radiologic technologist
  • Nursing staff as required

Risks and Complications

  • Mild discomfort during and after the procedure
  • There is a risk of infection, though it is very rare
  • Allergic reaction to the contrast dye (rare)
  • Minor bruising or bleeding at the site of cannula insertion

Benefits

  • Accurate diagnosis of breast duct abnormalities
  • Helps in the early detection of potential breast cancers
  • Can guide further treatment decisions

Recovery

  • Mild soreness at the nipple site which resolves in a couple of days
  • Patients can typically resume normal activities immediately
  • Follow-up with your doctor for the results and any necessary additional testing or treatment

Alternatives

  • Breast ultrasound
  • MRI of the breast
  • Clinical breast examination

    Pros: Non-invasive options like ultrasound or MRI might be preferred for initial screening. Cons: They may not provide as detailed images of the ductal structures as a ductogram.

Patient Experience

Patients may feel slight pressure or discomfort during the dye injection. After the procedure, some tenderness or mild bruising may occur. Pain management usually involves over-the-counter pain relief if necessary. Effective communication with the healthcare team can help manage anxiety and enhance comfort.

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