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Galactography: method of choice in pathologic nipple discharge?
M A Funovics1, M O Philipp, B Lackner
1Department of Radiology, University of Vienna Medical School, Vienna General Hospital, Währinger Gürtel 18-20, 1090 Vienna, Austria. martin_funovics@yahoo.com
European Radiology
|January 24, 2003
Summary
Galactography is a sensitive but unspecific tool for diagnosing nipple discharge, with normal results indicating absence of disease. Exfoliative cytology offers better specificity for carcinomas but lower sensitivity.
Area of Science:
- Radiology
- Pathology
- Oncology
Background:
- Pathological nipple discharge requires accurate diagnosis.
- Galactography, exfoliative cytology, and secretion color analysis are diagnostic methods.
Purpose of the Study:
- To evaluate the diagnostic utility of galactography for pathological nipple discharge.
- To compare galactography with exfoliative cytology and secretion color analysis.
Main Methods:
- Retrospective analysis of galactography cases (1993-1998).
- Comparison of galactogram findings, cytology, and secretion color with postoperative histology or 2-year follow-up.
- Calculation of sensitivity and specificity for detecting carcinomas.
Main Results:
- Galactography showed sensitivity for carcinomas (e.g., filling defect 55.6%, ductectasia 22.2%).
- Normal galactograms were specific (93%) yet moderately sensitive (78%) for absence of disease.
- Exfoliative cytology had low sensitivity but better specificity for carcinomas.
Conclusions:
- Galactography is sensitive but unspecific for papillomas or carcinomas.
- Filling defects and ductal distortion increase suspicion for carcinoma.
- Secretion color analysis provided no significant additional diagnostic information.