The diagnostic value of galactography in patients with nipple discharge

To evaluate preoperative galactographic findings in the differentiation bet ween the benign and malignant lesions in patients presenting spontaneous ni pple discharge without mass. Of the 215 patients who have undergone the gal actography, 181 cases with abnormal galactography had surgery performed. Al l galactrograms were reviewed and galactographic findings were correlated t o the pathological results to determine diagnostic differentiation. Of the 181 cases we operated on, 112 cases were macroscopically bloody, with 30 ca ses having cancers (26.8%). Fifty-four cases with serous discharge had seve n cancer cases (13.0%). No cancer cases with other color discharge were fou nd. Of the 37 cancer cases, 11 cases had lesions located in the main mammar y ducts (lactiferous duct and the segmental duct) (29.7%) and 26 cases had lesions in the peripheral ducts (the subsegmental duct and its branches) (7 0.3%) (P<.05). Of 113 cases with benign proliferative ductal lesions, 88 ca ses were located in the main mammary duct (77.9%) and 25 cases in the perip heral mammary duct (22.1%) (P<.05). Otherwise, 29 cancer cases (82.9%) had ductal obstructions and 28 cancer cases (75.7%) had irregular intraductal d efects that appeared in the galactograms, which is different from the 113 b enign proliferative ductal lesion cases that had 88 cases (71.7%) with duct al dilatation and 90 cases (79.6%) with lobular or smooth intraductal defec ts (P<.05). These results showed that the cancer cases had a higher rate of locating in the peripheral duct, irregular intraductal duct defects, and d uctal obstruction, and a lower rate associated with ductal dilatation or to rsion. The galactographic findings were evaluated using the tumor location, types of intraductal defects, ductal obstruction, and dilatation. Preopera tive diagnostic galactography is useful in differentiating between the beni gn or malignant lesions in patients with spontaneous nipple discharge. (C) 2001 Elsevier Science Inc. All rights reserved.