ABSTRACT
BACKGROUND: The purpose of this study was to evaluate the usefulness of galactography (GL) in the early diagnosis of breast cancer in patients with pathologic nipple discharge (PND). PATIENTS AND METHODS: We retrospectively studied all galactograms obtained in 117 women with PND, who subsequently had a biopsy. The findings detected in the galactograms of the patients in this study were assigned to different categories of the Galactogram Image Classification System (GICS): GICS 2, benign; GICS 3, probably benign; GICS 4, suspicious for malignancy; and GICS 5, highly suspicious for malignancy. RESULTS: The galactograms were classified into GICS 2 (29 cases; 24.7%), GICS 3 (42 cases; 35.8%), GICS 4 (30 cases; 25.6%), and GICS 5 (16 cases; 13.6%). A good correlation was observed between histological diagnosis and GICS categories (p < 0.05). All cases diagnosed with carcinoma (n = 18) were classified in GICS categories 4-5: ductal carcinoma in situ in 14 cases (11.9%) and invasive carcinoma in 4 cases (3.4%). CONCLUSION: GL is a useful procedure in the early diagnosis of breast cancer in patients with PND.
ABSTRACT
BACKGROUND: A new system for the classification of galactograms is reported. To date, there is no universally accepted classification system. PURPOSE: To evaluate inter- and intra-observer agreement of the Galactogram Imaging Classification System (GICS) MATERIAL AND METHODS: Six observers with different levels of experience retrospectively evaluated 30 galactograms using the GICS. Images were reviewed independently twice within a four-week period. The kappa statistic was calculated for intra- and inter-observer variability. RESULTS: The kappa for inter-observer agreement was moderate to substantial (range 0.41-0.72). Overall, the intra-observer kappa values were excellent (range 0.80-0.94). CONCLUSION: The present study shows a good to very good inter- and intra-observer agreement with the GICS. We believe the GICS can be incorporated into daily practice.
Subject(s)
Breast Neoplasms/diagnostic imaging , Exudates and Transudates/diagnostic imaging , Mammography/methods , Nipples/diagnostic imaging , Adult , Breast Neoplasms/pathology , Chi-Square Distribution , Diagnosis, Differential , Female , Humans , Middle Aged , Nipples/pathology , Predictive Value of Tests , Reproducibility of Results , Retrospective StudiesABSTRACT
BACKGROUND: Galactography is the technique of choice for investigating pathological nipple discharge. However, there is no standardized interpretation system for this procedure. PURPOSE: To evaluate radiological and histological correlation using a Galactogram Imaging Classification System (GICS). MATERIAL AND METHODS: We retrospectively studied all galactograms obtained in 62 women with pathological nipple discharge who subsequently had biopsy at our institution between 1999 and 2007. The GICS proposes five categories for galactographic findings: GICS 1: negative; GICS 2: benign; GICS 3: probably benign; GICS 4: suspect for malignancy; GICS 5: highly suspect for malignancy. RESULTS: The galactographic findings were classified as follows: GICS 2: 25.8% (16/62); GICS 3: 30.6% (19/62); GICS 4: 25.8% (16/62); and GICS 5: 17.7% (11/62). A good correlation was observed between histological diagnosis and GICS categories (P < 0.05). All the cases diagnosed with carcinoma (n = 11) were classified in GICS category 5. CONCLUSION: The present study shows a good correlation between GICS categories and histological diagnosis.
