乳腺导管扩张症的诊断及治疗

Diagnosis and treatment of mammary duct ectasia

目的:探讨乳腺导管扩张症的临床特点、诊断和治疗。方法:对经手术和病理诊断的39例乳腺导管扩张症患者的临床资料进行回顾性分析。结果:行乳房肿块切除术22例,乳腺区段楔形切除术13例,单纯乳房切除术2例,乳腺瘘管切除术2例。其中36例获随访(92.3%),随访中复发7例,均经再次手术获治愈;另外,1例术后9个月于对侧乳房异时性发生本病;其余恢复良好。结论:乳腺导管扩张症临床表现多样,易误诊误治;术前细胞学检查和术中快速病理检查是避免误诊的重要手段。手术切除为其首选治疗方法,局部肿块切除或病变乳腺区段楔形切除为广泛采用的术式,禁忌贸然行广泛的切除术。

Objective To study the clinical characteristics, diagnosis and treatment of mammary duct ectasia. Methods Clinical data of 39 cases with mammary duct ectasia diagnosed by both operation and pathology were analyzed retrospectively. Results Breast mass resection, wedge-shaped resection, simple mastectomy and breast fistula resection were carried out in 22,13, 2 and 2 patient respectively. 36 cases were followed up （92.3%）,in which, 7 cases recurred, and cured after operation again. In addition, 1 case occurred in contralateral side after operation 9 months ago. Others recovered well. Conclusions The clinical manifestations of mammary duct ectasia are various, easily misdiagnosed and mistreated. Preoperative cytologic examination and rapid-pathologic examination during operation are important ways to avoid diagnostic errors. Resection is the primary treatment, while local mass resection or wedge-shaped resection is the commonly accepted operation. Moreover, extensive resection is forbidden.