What is a ductogram?

A ductogram, also known as a galactogram, is an imaging test used to identify the cause of nipple discharge. The ductography procedure is similar to a mammogram, except that a contrast dye is injected into the breast before the X-ray, to provide an even more detailed view of the milk ducts.

If you’re experiencing any discharge from the nipple, including blood, your care team may order a ductogram. The imaging test may also be recommended if an intraductal papilloma—a noncancerous tumor that resembles a wart—is suspected.

How to prepare

Doctors don't want anything to interfere with the X-ray, so you’ll need to take the following precautions before a ductogram.

Don't wear:

• Deodorant or antiperspirant underneath your arms
• Lotions or talcum powder either in your armpits or on your breasts
• Necklaces or other jewelry

It’s helpful for your care team to see the discharge right before the test, so don’t squeeze your nipple before the procedure.

What to expect

A ductogram takes place in a hospital or radiology clinic and typically lasts about 20 minutes to an hour. The procedure typically involves these steps:

• After removing clothing from the waist up, you may be asked to change into a gown and lie on an exam table.
• A radiation technologist, or another member of your care team, may clean the nipple area.
• The technologist may try to draw out discharge by gently squeezing the nipple. This may help find the affected duct.
• Next, a thin plastic tube may be inserted into the duct that has the leakage. This may produce some pressure, but should not be painful.
• In the last step, a small amount of contrast dye is slowly injected into the affected duct. On the X-ray image, this contrast may help light up the duct, so your care team may see its shape, as well as note any concerns, such as lumps, within the duct itself.

Once this is completed, you may be asked to stand in front of the mammogram machine. The breast may be flattened by two plates in order to get a clear image of the milk ducts filled with contrast. If this is uncomfortable, the technologist may be able to adjust the plates. You may be asked to stand still and hold your breath while the image is being taken.

The radiologist, or the doctor who reads the images, may ask you to wait while the images are reviewed. If the images aren’t clear, they may have to perform the test again.

What are the risks?

Since X-rays use radiation, there’s a risk of exposure to radiation from a ductogram. However, this test uses very small doses of radiation. An X-ray might slightly increase your risk for cancer, but it’s considered unlikely.

If you’re allergic to the contrast dye used for this test, it’s possible to have a reaction. Inform your care team if you’re allergic to contrast dye—or related allergens such as iodine or seafood—before the test, so they can make the best decision in your case.

Because a catheter, or small tube, is inserted into the milk duct, the possibility exists that an infection or injury to the milk duct may occur.

Follow-up care

Your doctor may call with the final results of the ductogram. In case of any concerns, your care team may recommend additional tests. You may require breast cancer surgery to remove the milk ducts, or—if a papilloma is found—surgery to remove the papilloma.