Galactography (Ductography)

How is the procedure performed?

This examination is usually done on an outpatient basis.

The patient is seated or placed on her back with the breast exposed. The nipple is cleansed, and a tiny amount of fluid is squeezed from the nipple to identify the duct with the discharge. The milk duct may be dilated to permit a small catheter (a plastic, hollow tube) or blunt-tipped needle to be inserted into the milk duct. Occasionally a warm towel will be placed on the breast to help the milk duct become more visible and to allow easier access to the milk duct. A small amount of contrast material is then injected, and a mammogram is obtained. A second injection and mammogram may be performed.

You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.

The procedure normally takes between 30 minutes and an hour.

Mri - Magnetic Resonance Imaging

The American Cancer Society has convened an expert panel to review new evidence regarding the use of Screening Breast Magnetic Resonance Imaging (MRI) for breast cancer. The expert panel reviewed this evidence and defined three levels of risk. These new recommendations are listed below. Please be aware that Screening Breast MRI does not replace mammography, but is considered an additional test. These recommendations are only for screening asymptomatic women, and do not apply to women who have symptoms or signs of breast cancer, including a lump or an abnormality on mammography or ultrasound.

1. Mri Breast Cancer Screening is recommended for women with a lifetime risk of 20 – 25% or greater for developing breast cancer. These include:

• Women with a breast cancer gene, BRCA1 or 2 (BReast CAncer 1 or 2).

• Women who are a first degree relative (parent, sibling, or child) of someone with a breast cancer gene.

• Women who have a lifetime risk of 20-25% based on a breast cancer prediction model determined primarily by family history, such as the BRCAPRO model.

• Radiation to the chest between age 10 and 30 years (such as is given for Hodgkin's Disease).

• Various rare syndromes that have a high incidence of breast cancer.

2. There is insufficient evidence to determine if mri Breast Cancer Screening is useful or not for:

• Women who have a lifetime risk of 15-20% based on a breast cancer prediction model determined primarily by family history, such as the BRCAPRO model.

• Lobular carcinoma in situ (LCIS) or atypical lobular hyperplasia (ALH).

• Atypical ductal hyperplasia (ADH).

• Dense breasts on mammography.

• Women with a personal history of breast cancer, including ductal carcinoma in situ (DCIS).

3. Mri Breast Cancer Screening is not recommended for women who have a less than 15% lifetime risk of breast cancer. This includes most women. Biopsies

A biopsy is the removal of tissue in order to examine it for disease. The tissue samples can be taken from any part of the body. Biopsies are performed in several different ways. Some biopsies involve removing a small amount of tissue with a needle while others involve surgically removing an entire lump, or nodule, that is suspicious.

Often, the tissue is removed by placing a needle through the skin (percutaneously) to the area of abnormality. Biopsies can be safely performed with imaging guidance such as ultrasound, x-ray, computed tomography (CT), or magnetic resonance imaging (MRI). These types of imaging are used to determine exactly where to place the needle and perform the biopsy.

When a nodule is detected, imaging tests may be performed to help determine if it is benign (non-cancerous) or malignant (cancerous). If imaging studies cannot clearly define the abnormality, a biopsy may be necessary.

Breast biopsy is used to determine if a lump in the breast is cancerous or benign. It can be performed a number of ways:

• Stereotactic (mammographically-guided)

• Ultrasound-guided

• MRI-guided