乳头血性溢液的临床病理特点与治疗  

Clinicopathological features of bloody nipple discharge

作　　者：徐海滨[1] 苏昆仑[1] 胡祖健[1] 何俊玲[1] 胡望华[1] 

机构地区：[1]浙江中医药大学附属广兴医院乳腺外科,浙江杭州310006

出　　处：《实用肿瘤杂志》2008年第2期155-157,共3页Journal of Practical Oncology

摘　　要：目的探讨乳头血性溢液的临床病理特点和治疗方式,为乳头血性溢液的临床诊断和治疗选择最佳方案提供依据。方法回顾性分析435例病理性乳头溢液患者的临床资料。对比分析血性溢液与非血性溢液的临床病理特点和血性溢液病例中,良、恶性病变的临床资料以及不同的手术方式。结果血性溢液组58.9%的病例为导管内乳头状瘤,而非血性溢液组最为常见的是增生性疾病(38.7%)。血性溢液组乳腺癌占14.0%,非血性溢液组乳腺癌占7.0%。在影像学诊断上,MRI与乳管内视镜可更有效发现病变。乳管镜引导下的切除手术比亚甲兰染色法更准确和安全。结论血性溢液最常见的疾病是导管内乳头状瘤,而非血性溢液多是增生性疾病所致。若血性溢液合并有临床可触及的肿块则应警惕乳腺癌的存在。乳管镜引导下的切除手术可准确定位,是一种安全有效的方法。Objective To identify the clinicopathological features of bloody nipple-discharge. Methods The medical records of 435 patients with pathologic nipple discharge （PND） who were admitted from June 2001 to May 2006 were reviewed; the findings of imaging study and methods of surgical intervention were also analyzed. Results Papilloma was the most common diagnosis （58. 9%） in patients with bloody nipple discharge, whereas hyperplasia was the most common diagnosis in patients with non-bloody nipple discharge. The incidence of carcinoma was 14.0% in patients with bloody nippledischarge compared with 7. 0% in patients with non-bloody nipple discharge. In breast image studies, MRI and mammary ductoscopy were more accurate than others. Mammary ductoscopy-directed duct excision for PND was safer and more effective procedure than intraductal injection of methylene blue dye to assist in major duct excision. Conclusion Patients with bloody nipple-discharge and a palpable mass are in high risk of breast cancer. Mammary ductoscopy for PND is a safe, effective procedure for maior duct excision.

关 键 词：乳腺肿瘤/病理学 乳溢 导管切除术 

分 类 号：R655.8[医药卫生—外科学] R737.9[医药卫生—临床医学]