What is a galactogram?
Galactography (ductography) is a procedure to image the ducts within the breast to investigate the causes of specific types of nipple discharges. It requires the use of x-ray dye (to create contrast) and mammography.
Why are galactograms performed?
Galactograms investigate the causes of bloody or clear nipple discharges. Nipple discharges can be caused by several reasons. It is important your doctor know if the bloody or clear discharge occurred spontaneously (on its own), following an injury, during compression, or only expressed by pressure on the nipple. A galactogram is done to determine if there is a lesion and its location within the breast. This information is required for the surgeon so that it can be removed.
Make sure to inform the Breast Health Centre if you have had a reaction to x-ray dye in the past. If you have severe allergies, especially to x-ray dye, you may require premedication.
The success of the galactogram may be compromised if you have had previous surgery around the nipple.
How is the procedure done?
- No special preparations are necessary for your galactogram except that we ask you do not squeeze or express any fluid from your nipple before your appointment. The fluid is needed to identify which duct to examine, and there may only be a small amount left.
- The radiologist will explain the procedure, answer your questions and obtain your consent to proceed. The radiologist will then try to express some discharge or ask you to express the discharge. Each breast can have 20 to 25 ducts and therefore identifying the duct with the fluid is critical before the exam can begin.
- If fluid does not readily present itself, the radiologist may gently massage your breast or warm towels may be placed on your breast as this can encourage the discharge to release.
- Once the fluid discharges, you will be reclined in our chair, your nipple will be cleaned and a very small, blunt ended probe will be gently inserted into the discharging duct. Some gentle pressure may be applied to help ease the probe in, but it is never forced.
- Once in place, the probe will release a small amount of dye. There should be no pain, but you may feel fullness in the breast. The probe will then be taped to your breast so we can sit you up and take images of your nipple and the ducts leading to it. More dye may be injected as different images are taken.
- The probe is then removed. Any dye in your breast will either discharge on its own or some may be absorbed by your body.
- The results may be available on the same day, Your family physician will receive the report and arrange any further management.
What happens if there is no discharge the day of exam?
If it is not possible to express any discharge on the day of the exam, or if you have not had any discharge for quite some time, the exam may be postponed to a later date. You should contact your doctor and the Breast Health Centre if the discharge should reoccur.
Are their limitations?
The biggest limitation is not being able to express any fluid from the duct. If we cannot identify which duct the discharge is from, we cannot do the exam as there are many ducts opening to the nipple.
If a duct is very small, we may not be able to dilate it enough to insert the probe.
If you have questions or concerns, contact the Breast Health Centre at 306-655-8686. Our office is open Monday to Friday. 7:30 am to 4:00 pm.