Ductal abnormalities detected with galactography: frequency of adequate excisional biopsy

Galactography (ductography) is a contrast examination of the mammary ducts performed to identify and localize intraductal growths that may be the cause of spontaneous discharge from the nipple. The objective of this study was to correlate the radiologic-pathologic findings in patients with abnormal findings on galactograms in order to determine how often the biopsy specimens included the lesions seen at galactography. We retrospectively studied all galactograms with abnormal findings obtained in women who subsequently had biopsy at our institution between 1981 and 1991. Galactograms and tissue specimens from 29 women who had 30 biopsies were included. The standard technique was used to perform galactography. Biopsies were performed by using standard surgical technique for duct excision. The histopathologic findings were retrospectively reviewed by a pathologist to determine whether the biopsy specimens included the lesions seen at galactography. In six (20%) of the 30 biopsies, the lesion shown by galactography was not seen on histopathologic review. In the other 80%, the lesion was successfully identified on histopathologic examination. Our finding that the abnormality shown by galactography was not completely excised in one in five cases indicates that greater cooperation between the surgeon, radiologist, and pathologist is essential to ensure that all lesions are properly removed.