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EDUCATION EXHIBIT |
1 From the Susan G. Komen Breast Center, 4911 Executive Dr, Peoria, IL 61614; the Department of Radiology, University of Illinois College of Medicine at Peoria; the Department of Radiology, OSF Saint Francis Medical Center, Peoria; and Peoria Radiology Associates. Recipient of a Certificate of Merit award and an Excellence in Design award for a scientific exhibit at the 1999 RSNA scientific assembly. Received March 1, 2000; revision requested May 16 and received July 19; accepted August 3. Address correspondence to S.H.S. (e-mail: sslawson@pol.net).
Ductography of the breast is an underused procedure that often helps define the cause of unilateral, single-pore, spontaneous nipple discharge. Since nipple discharge may be caused by benign tumors, such as papillomas, or by carcinoma, such as ductal carcinoma in situ, identification of intraductal abnormalities with ductography is important. Further, diagnostic ductography and preoperative ductography help guide accurate surgical intervention. Without prior ductography, central duct excision may not result in removal of the abnormal ductal tissue or may result in removal of only a portion of the abnormal ductal system, causing the extent of disease to be effectively understaged. Once fundamental ductographic principles are learned, the procedure is easy to perform. If extravasation occurs, ductography is rescheduled for 7–14 days later. Elimination of air bubbles from the cannula, syringe, and extension tubing is vital. When reflux occurs, radiologists must be aware of a possible tumor in the distal-most duct. When ductal ectasia or fibrocystic changes are the cause of the discharge, conservative follow-up may be considered. Diagnostic radiologists who learn the technique of ductography and include it in their evaluation of nipple discharge will improve their interdisciplinary approach to this important sign of breast cancer.
Index Terms: Breast, ducts, 00.127 • Breast neoplasms, diagnosis, 00.312, 00.324 • Galactography, 00.127
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