乳头溢液性乳腺癌的选择性乳腺导管造影表现

Selective galactography features in breast carcinoma patients with nipple discharge

目的探讨选择性乳腺导管造影对溢液性乳腺癌的诊断价值。方法回顾性分析病理确诊的39例伴溢液的乳腺癌患者的乳腺导管造影表现。结果 39例中导管内乳头状癌7例,导管内癌13例,浸润性导管癌19例。乳腺导管造影主要表现为:导管内充盈缺损24例(61.5%),导管中断15例(38.5%),僵硬或紊乱31例(79.5%),虫蚀征18例(46.2%),潭湖征4(10.3%),断续征17例(43.6%),狭窄24例(61.5%),扩张22例(56.4%)。对于39例乳腺癌,单纯乳腺钼靶平片诊断符合率为64.1%(25/39),导管造影诊断符合率为87.2%(34/39),高于前者,差异有统计学意义(P<0.05)。对于13例导管内癌,单纯乳腺钼靶平片诊断符合率为61.5%(8/13),导管造影诊断符合率为100%,高于前者,差异有统计学意义(P<0.05)。结论选择性乳腺导管造影可提高乳腺癌的检出率,对导管内癌的早期诊断更具独特诊断价值。

Objective To detect the features of breast carcinoma with nipple discharge using selective galactography and evaluate the value of this method. Methods The galactography findings of 39 cases of pathology proved breast carcinoma with nipple discharge were analyzed retrospectively. Results Among the 39 cases, the pathology diagnosis included 7 cases of intraductal papillary carcinoma, 13 cases of ductal carcinoma in situ, and 19 cases of invasive ductal carcinoma. The galactographic features included： duct filling defect （24 cases, 61.5%）, ductal obstruction （15 cases, 38.5%）, rigidity and disorder （31 cases, 79.5%）, wormy erosion sign （18 cases, 46.2%）, pond lake sign （4 cases, 10.3%）, ductal interruption （17 cases, 43.6%）, ductal stenosis （24 casesm, 61.5%）, ductal dilatation （22 cases, 56.4%）. Among all of the cases, the accuracy rate of mammography and galactography was 64.1% （25/39） and 87.2% （34/39）, respectively （P〈0.05）. Among the 13 cases of ductal carcinoma in situ, the accuracy rate of mammography and galactography was 61.5% （8/13） and 100% （13/13）, respectively （P〈0.05）. Conclusion Selective galactography could improve the detection rate of breast carcinoma, and has great value in the early diagnosis of ductal carcinoma in situ.