Mammary ductography

I believe that many people do not know how to perform breast ductography, nor do they know what disease the results of breast ductography mean. Therefore, everyone can learn more about medical knowledge, which will be helpful for us to prevent diseases. The normal value of breast ductography is negative, but a positive result may be due to breast tumors and dilation of the breast ducts.

Mammary ductography is an examination method in which contrast agent is injected into the milk duct and then an X-ray is taken to show ductal lesions.

Normal value

The test results were negative.

Clinical significance

Abnormal results:

The test result was positive.

Intraductal papilloma: Angiography often shows a round shape inside the duct, smooth edges, filling defects, and the proximal duct is often dilated and widened.

Duct dilatation: manifested by the loss of normal dendritic morphology of the ducts at all levels, segmental widening or expansion into a cystic shape. In some cases, due to excessive secretions in the ducts, in addition to the widening of the ducts, continuous irregular areas of reduced density can be seen in the ducts, making the edges of the ducts appear less sharp.

Breast hyperplasia: A 10cm×10cm mass was palpated clinically, with ducts at all levels uniformly widened and extended, and slightly compressed around the mass, with several small cystic dilations seen at the end of the ducts. Fifteen cases with combined ductal dilatation also showed X-ray changes of ductal dilatation.

Breast abscess and mastitis: The contrast agent directly enters the abscess cavity, the shape is irregular, the duct behind the areola becomes thinner, the branches are reduced, and the duct edge is blurred.

Breast cancer: Duct angiography and X-ray angiography changes are not the same.

In invasive ductal carcinoma, a hard mass can be felt behind the areola; molybdenum target films show that the mass is irregular, of medium density and uneven, with piles of muddy calcifications in and around the mass; angiography shows that the duct is interrupted in front of the mass, the stump of the duct is irregularly destroyed and stiff, and the duct is not thickened.

Clinically, a hard, fixed mass was palpated with bloody discharge; molybdenum target films showed that the mass had uneven density and irregular edges, with thick and twisted drainage blood vessel shadows around it; angiography showed irregular destruction of the posterior wall of the main tube, with the wall being rigid, and the distal small ducts being thin and messy, distributed in a thread-like shape, and concentrated on one edge of the mass.

People who need to be examined: People who feel lumps in their breasts.

Precautions

Unsuitable group: breastfeeding women.

Contraindications before examination: Check whether you are allergic to contrast agent.

Requirements during the examination: Relax during the examination. The examination may cause physical and mental burden, so you should face it positively and actively cooperate with the examination. The examination requires exposing your breasts, so you should wear clothes on your upper body that are easy to take off. For patients with breast disease who are initially diagnosed, if the physical examination is not satisfactory, the patient can be asked to cooperate and undergo another examination at the best time, such as around the 10th day of the menstrual cycle, to avoid interference caused by physiological changes in the breast during the menstrual cycle. Adequate lighting should be provided during the examination to avoid overlooking signs caused by minor lesions.

Inspection process

Routinely disinfect the affected nipple, then squeeze the nipple to find the discharge duct opening. After cleaning the secretions on the surface of the duct opening, use a No. 412 syringe needle (with a flat tip) to slowly insert 1-1.5cm into the milk duct, and slowly inject 0.5-3ml of 60% diatrizoate. After the needle is removed, one lateral and one axial radiograph should be taken immediately without applying pressure or with slight pressure to prevent the contrast agent from spilling out. The voltage under projection conditions can be slightly higher than that of flat films.

Related diseases

Mammary duct ectasia, intraductal papilloma, intraductal papilloma, breast cancer in the elderly, cystic breast hyperplasia, nipple discharge, breast cancer, breast tuberculosis, breast hyperplasia

Related symptoms

Breast hypertrophy, incomplete breast degeneration, breast pain, lobular hyperplasia, breast tingling