Values of contrast galactography in nonlactating nipple discharge in Korean women

Oh, K K; Park, Y H; Ji, H; Park, C Y

Abstract

Nipple discharge is a relatively frequent initial symptom of a pathologic lesion in the nonlactating breastwhich brings the patient to the physician for tretament. Eventhough only stressful significance of a sanguinous discharge, all type of nipple discharge will indicate that abnormal nipple discharge is a symptom of a pthologic change in the ductal and secretery susrem of the breast, and glactogram often offers information to etiology. Galactography using water soluble contrast media is a valuable procedure to evaluate women with nonlactational nipple discharge or bleeding which are usually due to benign diseases such as intraductal papillomma,papillomatosis, secretory diseases or malignant lesions. contrast galactography can often accomplish such localization and sometimes can suggest or confirm the nature of the pathologic process. Authors have experienced 5077 cases of mammograms, and among them, 195 cases with nipple discharge gave been at Youndong SeveranceHospital. Yonsei University since October 1, 1983 through June 10, 1988. The results were: 1. Incidence ofnonlactating nipple discharge was 3.9% among 5077 cases. 2. Most frequnet histopathologic disease among surgicallyconfirmed 100 cases was papilloma(35%), which was followed by papillomatosis(29%), fibrocystic disease(14%) andthen breat carcinoma(13%). 3. Age distribution of patient of nonlactating nipple discharge showed no differences in comparing to the patients with the same histopathologic disease without nipple discharge. 4. Bloody nipple discharge is the commonest finding(61%) which was followed by serous (22%), milish(8%), and thenserosanguinous(5%) nipple discharge, In analyzing relationship between histopathologic diagnosis and nippledischarge, papilloma and papillomatosis had bloody nipple discharge(69%, 57%), frequently and serous nipple discharge(26%, 25%). Breat cancer had mostly bloody and 28% milkish nipple discharge. 5. Galactographiccharacteristics of papilloma were single duct dilatation (63%) with single intraductal filling defect (66%) alongwith ductal obstruction (31%). Papillomatosis showed single duct dilatation with numorous filling defects(79%) andtortousity(25%). Breast carcinoma showed ductal obstruction (69%), irregular filling defects (79%) andtortousity(25%). Breast carcinoma showed ductal obstruction (69%), irregular filling defects(54%) intraductalcalcification (38%), periductal mass(38%) with easy extravasation of contrast media(23%). Fibrocystic disease hadalmost normal findings with tortousity, mild stenosis and cyst formation. 6. Galactographic study was the method of choice to put exact diagnosis of the lesion in the lactiferous duct. Diagnostic accuracy of papilloma 83%, papillomatosis 81%, breast cancer 92%, breast abscess and fibrocystic disease 100, respectively.