CPT® Code 77054

1. Indications

The mammary ductogram or galactogram, represented by CPT® Code 77054, is indicated for various clinical scenarios involving the mammary ducts. These indications may include:

• Investigation of Nipple Discharge This procedure is often performed when a patient presents with abnormal nipple discharge, which may indicate underlying ductal pathology.
• Assessment of Ductal Obstruction It is utilized to evaluate potential blockages within the mammary ducts that could lead to complications such as mastitis or abscess formation.
• Evaluation of Ductal Lesions The galactogram can help in identifying and characterizing lesions or masses within the ducts, aiding in the diagnosis of conditions such as ductal carcinoma in situ (DCIS).
• Preoperative Planning This imaging technique may be employed to provide critical information prior to surgical interventions involving the breast, ensuring that the surgical team is well-informed about the ductal anatomy.

2. Procedure

The procedure for a mammary ductogram or galactogram involves several key steps that ensure accurate imaging of the mammary ducts. These steps include:

• Step 1: Patient Preparation The patient is positioned comfortably, and the breast area is prepared for the procedure. This may involve cleaning the skin to reduce the risk of infection.
• Step 2: Cannulation of the Duct A needle and cannula are carefully inserted into the duct of interest. This step is crucial as it allows for the introduction of the radiopaque contrast agent into the duct system.
• Step 3: Injection of Contrast Agent Once the cannula is in place, a radiopaque substance is injected into the duct. This contrast agent enhances the visibility of the ductal structures during imaging.
• Step 4: Radiographic Imaging After the contrast agent is injected, radiographic images are taken to visualize the ducts. Multiple images may be captured to ensure comprehensive assessment of all relevant ductal areas.
• Step 5: Removal of Cannula Following the completion of imaging, the needle and cannula are removed from the duct. The area may be cleaned again to ensure patient comfort and hygiene.

3. Post-Procedure

After the mammary ductogram or galactogram, patients may be monitored briefly to ensure there are no immediate complications from the procedure. It is common for patients to experience mild discomfort or tenderness in the breast area, which typically resolves quickly. Patients are usually advised to avoid strenuous activities for a short period following the procedure. The results of the imaging will be interpreted by a radiologist, and findings will be communicated to the referring physician for further management or treatment planning as necessary. Follow-up appointments may be scheduled to discuss the results and any additional steps that may be required based on the findings.