I have had spontaneous bloody (sometimes yellow/orange)discharge from left breast going on a year in November. If expressed, the blood comes out in a drop surrounded by a clear sticky fluid. Periodic sharp pains and ongoing dull ache in l.breast and armpit-no palpable lump and both mammogram/ultrasound have come back negative. My left breast has become significantly larger in the last 2 to 3 yrs, and I have what appears to be a "cellulite" looking difference to the left breast that can usually only be seen in ambient light. (No skin lumpiness on the r. breast) My surgeon has suggested a galactogram in December. My questions: Is the "cellulite" appearance on the breast normal? What can I expect with the galactogram? Is the galactogram the same as a ductogram? Also, the surgeon discussed doing a biopsy of the duct that is leaking...how accurate are the biopsies when there is no lump present? Thanks!!
Dear roxymorr: A galactogram and a ductogram are the same. This test is a special type of contrast enhanced mammography used for imaging the breast ducts. Ductography can aid in diagnosing the cause of an abnormal nipple discharge and is valuable in diagnosing intraductal papillomas and other conditions. Papillomas are wart-like, non-cancerous tumors with branchings or stalks that have grown inside the breast duct; they are the most common cause of nipple discharge. A biopsy of the cells from the duct may tell them if there are any abnormal cells or whether the cells appear normal.
My opinion is that ductogram/galactogram (same thing) isn't all that useful. In the vast majority of cases of bloody discharge, there's not a lump or a finding on mammogram, because what causes the blood usually is within the duct only. Whereas it's true that a ductogram may show something, it still needs removal to be sure what it is; and that's true even if the ductogram shows nothing, which it might. If the ductogram shows something, it can provide a "target" for the biopsy; but if nothing shows, what's done is to indentify (sometimes by injecting dye into it at the time of surgery) the duct and follow it and remove it. So many surgeons omit the xray part and just doe the duct excision. Around 90% of the time it turns out to be something non-cancerous, such as a papilloma (which is a wart-like growth). But since cancer is a possibility, it's pretty well agreed that when there's blood, a surgical biopsy needs to be done.
No one commented on your remark about "cellulite" appearance on the breast, or that one breast is definitely larger than the other.
If the "cellulite" appearance to the skin also resembles the skin of an orange, or seems thicker than the skin on the other breast, or has ridges in the skin, you need to see a breast surgeon right away to rule out an uncommon type of breast cancer called inflammatory breast cancer. Your symptoms could be unrelated, but for peace of mind, do see a doctor who is familiar with it, OK?
BTW--I had never heard of it until I was diagnosed with it 14 months ago.
For more information, visit either of these web sites:
Sorry, forgot to mention a couple more very important points--inflammatory breast cancer usually will not show up on a mammogram because it's in the lymphatic channels in the breast skin. And on an ultrasound, the only indicator may be a thickened area of skin. You don't have to have a lump to have breast cancer.I, too, had stabbing pain in the affected breast.
Good luck, and I'm keeping my fingers crossed for you that it turns out to be nothing at all!
Thanks for the info/feedback-the surgeon I have is not a breast specialist, and is actually a physician who had previously misdiagnosed a blockage to the bile duct. So needless to say, I am somewhat concerned if he is actually the person doing the reading of results on galactogram
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