45-year-old woman with new onset of unilateral spontaneous, bloody nipple discharge. Initial workup with mammogram and ultrasound was unrevealing. As the patient had severe claustrophobia, she was unable to undergo MRI. A: Galactogram craniocaudal view revealed multiple abnormalities, including numerous filling defects (arrow, zoomed view, B), apple-core-like duct narrowing (dashed arrow, zoomed view, C), and duct obstructions (A, open arrow). After galactography, “second-look” ultrasound (D) identified the most suspicious areas, corresponding to the findings seen on ductography. Ultrasound showed multiple dilated ducts with surrounding vascularity (power Doppler, E), thickened walls, and intraductal hypoechoic material (arrows), BI-RADS 4 – suspicious. Biopsy demonstrated ductal carcinoma in-situ.