Galactogram showed filling defect...

CalmMeDown

Hello everyone...

I first noticed drainage from my left Breast February 1st. The drainage is clear looking but on my clothing it appears tea stained. It is a spontaneous drainage. My last mammogram was in October 2015 and I have never had any issues. I called my PCP that week to get a diagnostic mammogram and ultrasound scheduled. Those tests were done February 7th with no findings of anything wrong. I was scheduled for a galactogram on February 21st and the radiologist found a filling defect. The dye was not able to even go into the tree-root like ducts because of the blockage. I was shown the pictures and sure enough you could see a mass of some sort in the duct fully blocking it. He also found calcifications in the breast as well. BIRADS 4 and scheduled for a consultation with a breast specialist at Siteman Cancer Center in STL. The Appt is next week on Thursday. Any ideas or anyone ever have a total blockage that was not cancerous? Trying to stay calm but I'm not sleeping much.

Moderators

Hi CalmMeDown-

We know how stressful the waiting can be! It's important to remember that BIRADS 4 masses routinely come back benign, and we hope that this is the case for you! Please keep us posted on how your appointment goes, we'll be thinking of you!

The Mods

djmammo

Calm

I have done many galactograms over the years and yes there are benign causes for an abnormal exam. I have seen debris within the ducts cause obstructing and non-obstructing filling defects. Bubbles of air introduced during the exam can also cause a filling defect but these are usually correctly identified due to their classic appearance.

Our protocol called for an US immediately following the galactogram (aka ductogram) in an attempt to see the intraductal nodule, now knowing where it is. If we seen it on the US as well we know it is real. It presents as a small intraductal mass with internal blood flow.

On the day of surgery we place a localization wire through the finding seen at US so that the surgeon can excise it. Pathology is then able to evaluate the lesion as a whole and get you a more accurate diagnosis.

If it was not also seen on US we would repeat the ductogram and place a localization wire through the finding in a mammographic room. More than once I have seen complete resolution of the findings previously seen on galactography leading us to assume it was debris, and cancel the surgery.