病变导管选择性腺叶切除术对病理性乳头溢液的疗效分析

Therapeutic Effect of Lesional Ductal Selective Ductectomy for Pathological Nipple Discharge

目的:分析病变导管选择性腺叶切除术对病理性乳头溢液的治疗效果。方法:选择2011年10月-2017年12月在笔者所在医院接受手术治疗的134例病理性乳头溢液患者为例,所有患者均行病变导管选择性腺叶切除术治疗。随访12个月,统计患者的术后病理、乳头溢液复发与否、手术结局等情况。结果:134例患者手术治疗总有效率为97%(130/134);术后复发6例,两次均为导管内乳头状瘤,再次手术随访12个月,2例无再次复发,4例二次术后随访期内再次复发。4例乳腺癌,其中3例为原位癌,1例为浸润癌(微浸润),均为早期,均避免了切乳、化疗。结论:病变导管选择性腺叶切除术是病理性乳头溢液最为可靠的诊疗手段,可作为病理性乳头溢液首选的有效治疗手段,能及时诊断病变的病理类型,并去除病变,对发现具有癌变倾向的导管内乳头状瘤及早期乳腺癌具有重要的临床意义。

Objective:To analyze the therapeutic effect of selective ductectomy for pathological nipple discharge.Method:A total of 134 patients with pathological nipple discharge who underwent surgery in our hospital from October 2011 to December 2017 were enrolled.All patients underwent lesional ductal selective ductectomy.Followed up for 12 months,and the postoperative pathology,recurrence of nipple discharge,and surgical outcome were counted.Result:The total effective rate of 134 patients was 97%(130/134).There were 6 cases of postoperative recurrence.Both were intraductal papilloma.The patients were followed up for 12 months.Two patients had no recurrence,and 4 patients had recurrence during the second postoperative follow-up period.Four cases of breast cancer,including 3 cases of carcinoma in situ and 1 case of invasive carcinoma(micro infiltration),all were early,and avoided mastectomy and chemotherapy.Conclusion:Lesion-selective ductectomy is the most reliable method for the diagnosis and treatment of pathological nipple discharge.It can be used as the first choice for pathological nipple discharge.It can diagnose the pathological type of lesions in time and remove the lesions.It is important for the discovery of intraductal papilloma with early cancerous tendency and early breast cancer.