纤维乳管镜对病理性乳头溢液的诊疗价值

Evaluation of fiberoptic ductoscopy in diagnosis and treatment of pathological nipple discharge

目的探讨纤维乳管镜对病理性乳头溢液的临床诊疗价值。方法回顾性分析北京市通州区妇幼保健院乳腺外科2018年10月至2019年6月313例病理性乳头溢液患者病例资料。结果313例病理性乳头溢液患者行纤维乳管镜检查,其中124例为占位性病变行手术治疗。术后病理发现导管原位癌6例,小叶原位癌1例,非典型增生5例,导管内乳头状瘤病5例,多发导管内乳头状瘤6例,导管内乳头状瘤38例,纤维腺瘤4例,乳腺腺病9例,乳腺增生症50例。结论纤维乳管镜可直接诊断病理性乳头溢液的病因。纤维乳管镜引导下导丝定位手术更能准确切除导管内病灶。纤维乳管镜能发现仅仅表现为乳头溢液的早期乳腺癌。

Objective To explore the clinical value of fiberoptic ductoscopy in the diagnosis and treatment of pathological nipple discharge.Methods A total of 313 patients with pathological nipple discharge from October 2018 to June 2019 in the Breast Surgery Department of Tongzhou Maternal&Child Health Hospital,Beijing were retrospectively reviewed.Results Fiberoptic ductoscopy was performed in 313 patients with pathological nipple discharge,124 cases were space occupying lesions and underwent surgical operation.Postoperative pathology confirmed 6 cases of ductal carcinoma in situ,1 case of lobular carcinoma in situ,5 cases of atypical hyperplasia,5 cases of intraductal papillomatosis,6 cases of multiple intraductal papilloma,38 cases of intraductal papilloma,4 cases of fibroadenoma,9 cases of breast adenosis and 50 cases of hyperplasia of mammary glands.Conclusions Fiberoptic ductoscopy can directly diagnose the etiology of pathological nipple discharge.The guide wire localization surgery guided by fiberoptic ductoscopy can more accurately remove the intraductal lesions,and fiberoptic ductoscopy can detect early breast cancer by nipple discharge.