Conventional Galactography in the Management of Suspicious Nipple Discharge :A forgotten Art?

Abstract

Background: Conventional Galactography is a simple procedure and a cheap tool in evaluating suspicious nipple discharge(SND). It accurately demonstrates the intraductal lesion for confident diagnosis and timely intervention. SND, a common symptom, occurs spontaneously and unilaterally from a single duct. Cancer has been found in some patients with SND.

Objective: To examine radiologists' knowledge and practice of galactography in the evaluation of SND and determine if training in performing galactography existed.

Methods: A Standardized structured questionnaire with 16 questions was served to radiologists in centres around Nigeria. Descriptive and inferential statistics were done where indicated with SPSS Version 20 (IBM Corp., Armonk NY, USA) and significance levels were set at p<0.05.

Results: 58 (64.4%) out of 90 questionnaires were returned. 58% had been in practice for between 11-20 years. 98% worked in departments where breast imaging was available. 26.8% of radiologists reported handling over 10 breast cases/week and SND was reported as a common complaint. Only 8% listed galactography among their department's protocol for managing SND and just 10.5% of respondents had received training to perform it. Only 31% had ever done the procedure. Of those who had performed it, 83% attested that it helped in resolving the cause of the SND.

Conclusion: In a resource-poor environment like ours where breast cancer is common and late presentation is the rule, galactography being a cheap tool, it stands to reason that radiologists should widely recommend and use it for early diagnosis. This however does not appear to be the case.