The structure of the mammary gland consists of three main parts - lobes, milk ducts and fat. If the female breast has undergone any disease, then diagnostic measures are first carried out, which are based on ultrasound of the organ, mammography and MRI. But despite the good informativeness of the methods, sometimes additional research is required. For example, ductography studying ducts.
What is breast ductography, how is this study carried out, what are the contraindications of the technique and much more will be described in the information provided.
Main features of the method
Breast ductography is an x-ray examination of the milk ducts of the mammary glands. At the same time, a contrast agent is injected into them. Doctors call this method of diagnosis one of the varieties of mammography. Another name for this manipulation, which is often used by medicalworkers, this is galactography.
What can reveal?
The procedure allows you to identify such violations:
- Narrowing or widening of the milk ducts.
- Neoplasms such as intraductal papillomas or cancers.
- Pathological areas in the gland.
- Reveal their specific location, number and size of formations.
Thus, the main advantage of ductography is the ability to detect neoplasms in the milk ducts, which is beyond the power of any other method. This is especially important when prescribing surgery, as it is possible to identify the exact location of the tumor.
Ductography is also able to confirm or refute such an unpleasant diagnosis as intraductal papillomatosis. An analysis of the contents of the nipples can also reveal this disease, but it is galactography that puts an end to it. It is very important to identify this disease, as it is often a background disease and a harbinger of oncology.
Referral for research can be obtained from a mammologist, oncologist, radiologist after ultrasound and MRI of the breast.
As you know, the most dangerous diseases of the mammary glands are cancers. They don't show up for a long time. Galactography, along with other research methods, allows you to identify the disease in its early stages.
The pros and cons of breast ductography you will read below.
Indications
Research may be shown to women who havedischarge from the nipples of red, brown, and sometimes serous color began. Doctors will suggest undergoing a galactography if there are suspicions of a number of diseases. Indications for breast ductography:
- cancers inside the ducts;
- breast adenoma;
- papilloma, which is located in the intraductal region;
- nodular diffuse mastopathy or suspected cystic formation.
But don't rely on ductography alone. It is imperative to pass a smear from the nipples for cytological analysis, detection of prolactin levels and breast tumor markers.
Contraindications
The presented procedure has a number of contraindications, in which the study is not prescribed.
Who is contraindicated for breast ductography:
- During pregnancy and breastfeeding.
- Because the contrast agent contains iodine, the procedure is contraindicated for those who are allergic to this component.
- If the smear showed the presence of atypical cells, then it is better not to perform ductography, as it contributes to their further spread to other tissues.
- With purulent discharge from the papillary region.
- If there is scarring on the nipple.
- Having an acute inflammation in the breast, such as an abscess or mastitis.
- Ductography of the breast is contraindicated if there is a tumor in the excretory ducts, and it can be felt at the same time. Galactographycontraindicated, as the procedure may contribute to the spread of the tumor further along the ducts.
If there are discharges from the nipples of a different nature, then first of all it will be necessary to take a smear for examination, and only after the results the doctor will determine the need for ductography.
Preparation for manipulation
Special preparation for ductography is not required. Sometimes the doctor recommends starting antispasmodics, such as Baralgin or Papaverine, a few days before the procedure.
It is forbidden to touch the breast before the examination, try to squeeze out the contents of the nipples or massage the mammary gland. Otherwise, there is a risk of injuring the organ.
Many women are interested in whether it hurts or not to do breast ductography? You don't have to worry about the pain. Often, women experience some discomfort during insertion of the cannula into the nipple. It will only last a few seconds. But if the patient is too sensitive, then the doctor can perform anesthetic manipulations.
How is the study done?
Breast ductography is a method that does not cause much discomfort, only women who are too sensitive notice pain during the examination.
The procedure will be performed in a separate room, where the patient will be asked to completely undress to the waist, and to remove body jewelry. In this case, the woman takes a horizontal position, namely, lies on her side, her hands are usuallyrise up. It is permissible to conduct the study while sitting. But at the same time, there should be good lighting.
First, antiseptics are applied, only after that you can proceed to the main manipulations.
At the request of the woman, an anesthetic is initially injected into the nipple. After the onset of its action, a catheter is inserted into the milk duct. Through it, a contrast agent enters the chest. The dimensions of the needle must comply with the following standards:
- Length - 6-8 cm.
- Lumen diameter - 1.0 mm.
Sometimes the doctor advises to take a pill "No-shpy" on the eve of the procedure. This is done so that vasospasm does not occur, since in such circumstances the doctor's further actions will be useless. Vasospasm can occur due to the patient's fear, as a result of the woman's pain or nervous condition.
After all of the above manipulations, the breast is placed on a special stand of the apparatus. A plate is placed over the chest, its pressure allows the contrast agent to completely disperse through the ducts. After that, x-rays are taken in two projections. Then the contrast agent must be removed from the ducts. The entire procedure takes approximately 30 minutes.
As soon as the pictures are sent to the attending physician, he will be able to decipher them. If pathological changes are present, additional diagnostics in the form of an MRI may be needed. Only after the final diagnosis is made, the doctor will select the appropriate treatment.
Disadvantages of the method
Ductography of the breast is a method that has its drawbacks, one of them is injury to the milk ducts. This happens due to the introduction of a catheter into them. But this condition does not require special treatment, and often such injuries go away on their own.
Possible adverse reactions
It should be remembered that ductography is not a completely safe procedure, so first of all, check with your doctor for a list of contraindications. Reviews of breast ductography are varied, some patients note the presence of adverse reactions, others tolerate the procedure easily and painlessly.
As a side effect, you may develop an allergy to the contrast agent injected into the chest cavity. Therefore, the doctor pre-tests for an allergic reaction. If incompatibility is found, then another substance is selected or the research method is replaced with another one.
Some patients, on the contrary, report an improvement after galactography and the use of a contrast agent, as the inflammation in the breast disappears and the discharge from the nipples disappears.
What is the difference between ductography and mammography?
Ductography is a type of mammography. The difference from mammography is that the ducts of the mammary glands are examined by introducing a contrast agent into them. Thanks to this, the doctor can see well-defined ducts and possible problems in the pictures,related.
Only this study can reveal the tumor process that originates in the ducts of the breast. It also clearly indicates the location of the tumor, which is extremely important during surgery.
Ductal cancer has become more common in recent years. It develops in the ducts of the mammary gland and spreads to other lobes of the breast. Therefore, ductography is considered the most relevant method for detecting the disease at an early stage. It is often prescribed as a prophylaxis for oncology.
Research transcript
Ductography of the breast is a technique by which the following pathological conditions in the organ can be detected:
- Wrong direction and course of the duct.
- Degree of prevalence of the lesion.
- The presence of formations in the mammary gland and their connection with the ducts.
- The presence of widened or narrowed sections in the channels, as well as cliffs.
- Presence of defects and presence of microcalcifications.
The following indicators indicate cancers:
- the appearance of a filling defect - in 14.2%;
- fuzzy borders in formations and destructive areas - in 57, 1%;
- in 14.2% of cases - a complete violation of the patency of the ducts and uneven breaks in them;
- the ducts are dilated, the contours are uneven, the presence of scattered microcalcifications, the presence of cystic dilatations, which is observed in 14.2%.
As soon as the pictures are in the hands of the attendingdoctor, he will be able to decrypt. If he finds pathological changes in the results of the analysis, then an additional examination will be needed to confirm the diagnosis. Only after several tests and instrumental studies can a final diagnosis be made. Appropriate treatment will then be given.
