Values of contrast galactography in nonlactating nipple discharge in Korean women

Nipple discharge is a relatively frequent initial symptom of a pathologic lesion in the nonlactating breast which brings the patient to the physician for treatment. Eventhough only stressful significance of a sanguineous discharge, all type of nipple discharge will indicate that abnormal nipple discharge is a symptom of a pathologic change in the ductal and secretery susrem of the breast, and galactogram 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 papilloma, papillomatosis, secretory disease 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 have been at Youndong Severance Hospital. Yonsei University since October 1, 1983 through June 10, 1988. The results were: 1. Incidence of non lactating nipple discharge was 3.9% among 5077 cases. 2. Most frequent histopathologic disease among surgically confirmed 100 cases was papilloma (35%), which was followed by papillomatosis (28%), fibrocystic disease (14%) and then 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%), milkish (8%), and then seroanguinous (5%) nipple discharge, in analyzing relationship between histopathologic diagnosis and nipple discharge, papilloma and papillomatosis had bloody nipple discharge (69%, 57%), frequently and serous nipple discharge (26%, 25%). Breat cancer had mostly bloody nipple discharge (85%), in contrast to the fibrocystic disease which showed 50% bloody and 28% milkish nipple discharge. 5. Galactographic characteristics of papilloma were single duct dilatation (63%) with single intraductal filling defect (66%) along with ductal obstruction (31%). Papillomatosis showed single duct dilatation with numerous filling defects (79%) and tortousty (25%). Breast carcinoma showed ductal obstruction (69%), irregular filling defects (79%) and tortousity (25%). Breast carcinoma showed ductal obstruction (69%), irregular filling defects (54%) intraductal calcification (38%), periductal mass (38%) with easy extravasation of contrast media (23%). Fibrocystic disease had almost normal findings with tortousity, mild stenosis and cyst formation. 6. Galactographic study was the method of choice to put exact diagnosis of the lesion on the lactiferous duct. Diagnostic accuracy of papilloma 83%, papillomatosis 81%, breast cancer 92%, breast abscess and fibrocystic disease 100, respectively.