Post-operative seroma causing spontaneous nipple discharge: diagnosis by galactography

Nipple discharge is a common breast complaint in women. Discharge in the post-operative patient for breast cancer is especially concerning, as these women are at higher risk for recurrent or new breast cancer. Galactography is a reliable method to evaluate nipple discharge, attempting to identify a mass that may cause the discharge within the duct of concern. We present two cases of women with spontaneous nipple discharge after lumpectomy for breast cancer. In both cases, evaluation with galactography demonstrated a post-operative seroma that communicated with a native breast duct, causing nipple discharge. This presentation of a post-operative seroma is important to recognize by breast surgeons and breast imagers. Galactography can play an important role in the work up of these patients, demonstrating etiology of the nipple discharge with greater confidence than other imaging modalities.