Role of Galactography in the Early Diagnosis of Breast Cancer

Abstract

Background: The purpose of this study was to evaluate the usefulness of galactography (GL) in the early diagnosis of breast cancer in patients with pathologic nipple discharge (PND). Patients and Methods: We retrospectively studied all galactograms obtained in 117 women with PND, who subsequently had a biopsy. The findings detected in the galactograms of the patients in this study were assigned to different categories of the Galactogram Image Classification System (GICS): GICS 2, benign; GICS 3, probably benign; GICS 4, suspicious for malignancy; and GICS 5, highly suspicious for malignancy. Results: The galactograms were classified into GICS 2 (29 cases; 24.7%), GICS 3 (42 cases; 35.8%), GICS 4 (30 cases; 25.6%), and GICS 5 (16 cases; 13.6%). A good correlation was observed between histological diagnosis and GICS categories (p < 0.05). All cases diagnosed with carcinoma (n = 18) were classified in GICS categories 4-5: ductal carcinoma in situ in 14 cases (11.9%) and invasive carcinoma in 4 cases (3.4%). Conclusion: GL is a useful procedure in the early diagnosis of breast cancer in patients with PND.

Diagnostic value of endoscopic appearance during ductoscopy in patients with pathological nipple discharge

“…Pathologic nipple discharge (PND) is defined as unilateral, nonphysiologic nipple discharge from a single duct unit. This symptom is reported in 5% to 8% of breast-clinic consultations [ 1 , 2 ]. Papilloma, as the most common cause, accounts for between 40% to 70% of the etiology of PND, followed by adenomatous or papillary epithelial proliferation.…”

Galactogram for Investigation of Pathological Nipple Discharge: A Forgotten Arrow in the Radiologists’ Quiver?

“…Nipple discharge has a prevalence of about 3%-10% and is the third most common breast-related complaint after mass and breast pain. [1,2] PND is defined as persistent, spontaneous, nonlactational, unilateral, and single-duct discharge. [2] PND is caused most commonly by benign lesions such as duct papillomas.…”

“…[1,2] PND is defined as persistent, spontaneous, nonlactational, unilateral, and single-duct discharge. [2] PND is caused most commonly by benign lesions such as duct papillomas. Nearly 6%-20% cases of PND are due to underlying malignancy such as ductal carcinoma in situ (DCIS) and invasive intraductal carcinoma.…”

“…Risk of malignancy is higher in women of age >50 years and in cases of hemorrhagic discharge. [2,3] Therefore, proper evaluation of every case of PND is critical.…”

“…Findings that are suggestive of a benign pathology include duct ectasia, macrodefects with concave meniscus, and cystic changes with ductal communication [Case 2, Figure 2]. Abrupt or irregular duct obstruction, duct wall irregularity, ductal stenosis and sacculations, micro filling defects, and contrast extravasation in a woman >50 years of age are suggestive of a malignant etiology [2] [Case 1, Figure 1]. Duct obstruction due to benign pathology is more often restricted to the periareolar region and involves the main or segmental ducts whereas carcinomas are more commonly located in the peripheral portions of the breast.…”