乳头溢液127例临床诊治分析

Analysis on Nipple Discharge of 127 Cases

目的探讨科学合理、便于推广应用的乳头溢液诊断和治疗方法。方法回顾分析127例乳头溢液的临床资料。结果127例乳头溢液中血性溢液39例(30.7%),浆液血性溢液42例(33%),浆液性溢液46例(36.3%)。经病理诊断为良性病变者103例(81.1%),乳腺癌21例(16.5%),乳腺导管上皮不典型增生3例(2.4%)。血性溢液中乳腺癌发生率23.5%(19/81),非血性溢液中乳腺癌发生率4.3%(2/46)。127例患者中行单纯乳腺腺叶区段切除术106例,单纯乳房切除+前哨淋巴结清扫术14例,乳腺癌改良根治术7例,术后随访6个月未发现乳头溢液复发、良性病变癌变及癌转移。结论病理学检查是乳头溢液定性诊断的唯一方法。手术治疗乳头溢液原发病是防治早期乳腺癌及癌前病变的有效措施。

Objective To investigate reasonable diagnostic and treatment for primary disease of nipple discharge. Methods The characteristics of 127 patients with nipple discharge were retrospective analyzed. Results Following retrospective review, 39 cases of bloody discharge, 42 cases of serous bloody discharge and 46 cases of serous discharge were found. Through the pathological diagnosis, 103 cases （81.1%） of benignancy, 21 （16.5% ） cases of breast cancer and 3 （2.4%） cases of atypical duct hyperplasia were discovered. Breast cancer in patients with bloody nipple discharge was 23.5% （ 19/81 ） , and 4.3% （2/46） in those with non - bloody discharge. All patients were treated with surgery, 106 patients underwent simply the lobe section of the breast gland surgery, 14 patients underwent simple mastectomy and sentinel lymph node dissection, 7 patients underwent modified radical mastectomy. After 6 months following up, recrudescence of nipple discharge, cancer and cancerous metastasis were not found. Conclusions Pathological examination diagnosis is the most important way to determine the cause of nipple discharge. Surgical treatment of the primary disease of nipple discharge is effective measure to prevent early breast cancer and precancerous lesions of breast.