不伴肿物乳头溢液124例分析

Nipple Discharge not Associated with a Lump——Analysis of 124 cases

:目的 深讨不伴肿物乳头溢液对检出早期乳腺癌及癌前病变的临床价值。方法 对12 4例不伴肿物乳头溢液患者 (其中浆液性溢液 47例 ,血性溢液 74例 ,脓性 3例 ) ,行手术治疗 ,先行病变导管切除 ,如为恶性 ,则行乳腺癌改良根治术。结果 本组病例良性者 115例 ,占 92 7% ,其中乳腺导管内乳头状瘤和乳腺囊性增生病占 79% ;乳头状瘤 (病 )伴瘤细胞或导管上皮增生活跃(癌前病变 ) 14例 ,占 11 3% ;乳腺癌 9例 ,占 7 3% ,9例患者均为血性乳头溢液 ,占血性溢液之12 2 % ,均为临床早期癌 (T0 期乳腺癌 )。

Objective To explore the clinical value of nipple discharge not associated with a lump in the detection of breast cancer in early stage and precancerous lesions.Methods From January,1992 to October,1998.124 patients with nipple discharge in the absence of a lump in the same breast were treated by operation.Among them,47 cases were serous discharge,74 cases were bloody discharge and 3 were purulent.All the patients were performed ductectomy or local excision at first,modificatory radical mastectomy were performed on 8 patients and mastectomy on 1 after the diagnosis of carcinoma having been confirmed.Results 115 cases were benign lesions in this group (account for 92 7%),in which ,intraductal papilloma and cystic hyperplasia 98(79%),papilloma or papillomatosis with active epithelial hyperplasia 14(11 3%)—precancerous lesions.All the nine cases of breast cancer were bloody nipple discharge(7 3%).The incidence of carcinoma in cases of bloody discharge was 12 2%.All of them were T 0 carcinoma.Conclusion Nipple discharge not associated with a lump has an important value in the detection of breast cancer in early stage and precancerous lesions.