乳头溢液的诊断及对策

Diagnosis and countermeasure of nipple discharge

乳头溢液是乳腺疾病的常见症状之一。非哺乳期乳头溢液多为病理性,病变常位于乳腺导管内或起源于乳腺导管内。乳头溢液中肿瘤标记物的检测和乳腺导管造影是两项重要的定性和定位诊断方法。乳头溢液的手术方式至少应采用病变导管所在腺叶的腺叶切除术。对于多发的导管内乳头状瘤,尤其是非典型性导管内乳头状瘤或导管内癌,可采用象限切除或皮下乳腺切除术,甚至单纯乳房切除术。如果导管内癌伴有微浸润癌或浸润癌,则手术后发生局部复发和转移的概率都增加,应考虑施行乳腺癌改良根治术。

Nipple discharge is one of the common symptoms in patients with breast disease. Non lactation nipple discharge is generally pathological, mostly due to the disease caused by intraductal lesions. Detection of tumor markers in nipple discharge and ductography are two important methods for qualitative and locating diagnosis. The nipple discharge disease should be operated at least with lobeetomy. For multiple intraductal papilloma, especially for atypical intraductal papilloma or intraductal carcinoma , quadrant resection or subcutaneous mastectomy or simple mastectomy are needed. The probability of local recurrence and metastasis after surgery is increased, if the intraductal carcinoma is associated with microinvasive or invasive cancer. Modified radical mastectomy should be considered.