以“乳头溢液”为主诉的22例乳腺癌诊断及病理分析

Analysis of the Diagnosis and Pathological Characteristics of 22 Breast Cancer Patients with a Chief Complaint of Nipple Discharge

目的研究以“乳头溢液”为主诉的乳腺癌的诊断方法及其病理特征。方法回顾性分析了22例以“乳头溢液”为主诉的乳腺癌的诊断方法,包括乳腺B超、乳腺X线、溢液涂片细胞学、乳管镜、术中冰冻切片检查及其病理特点。结果乳腺B超、乳腺X线、术中冰冻切片的检出率分别为11.8%、20.0%、35.7%。溢液涂片细胞学检查3例发现癌细胞,6例高度怀疑癌细胞;6例患者行乳管镜检查,未提示乳腺癌。病理检查为原位癌9例,浸润性癌13例。雌激素受体(ER)、孕激素受体(PR)、Her-2阳性率分别为80.0%、86.7%、33.3%。结论联合B超、乳腺X线、溢液涂片细胞学检查等手段可使乳腺癌的检出率有一定提高,对于有高危因素的患者仍应行乳腺导管切除活检。

Objective To study the diagnostic methods and pathological characteristics of breast cancer patients with a chief complaint of nipple discharge. Methods The diagnostic methods and pathological characteristics of 22 breast cancer patients with a chief complaint of nipple discharge were retrospectively analyzed. The diagnostic methods included breast B-ultrasonograpy, breast X-ray examination, smear cytology of nipple discharge, ductoscopy and introoperative frozen sections. Re- sults The detection rates of breast B-ultrasonograpy, breast X-ray examination and introoperative frozen sections were 11.8 %, 20.0% and 35.7% respectively. Smear cytology of nipple discharge detected cancer cells in 3 patients, and highly suspected cancer cells in 6 patients. Ductoscopy was performed on 6 patients, hut could not suggest breast cancer. Pathological results revealed carcinoma in situ in 9 patients and invasive breast cancer in 13 patients. The positive rate of ER, PR and Her-2 was 80.0%, 86.7% and 33.3% respectively. Conclusion The combined use of B-ultrasonograpy, breast X-ray examination and smear cytology of nipple discharge may increase the detection rate of breast cancer. Breast duct excisional biopsy should he performed in patients with high risk factors.