乳腺导管内乳头状瘤161例分析

目的:探讨乳腺导管内乳头状瘤的诊断和治疗方法.方法:对161例导管内乳头状瘤进行回顾性分析.结果:161例中单发病例143例,多发性病例18例,单发及多发病例中各有7例、2例恶变.41例行溢液脱落细胞学检查,其中18例(43.9%)与术后病理诊断符合;乳管造影51例,其中 29例(56.9%)与术后病理诊断一致.本组良性病例行乳腺区段切除或肿块切除;恶性病例行改良根治术、乳腺单纯切除或肿块扩大切除,术后随访1～7年无复发.结论:乳管造影及溢液脱落细胞学检查是术前诊断乳腺导管内乳头状瘤的较好方法,乳头状瘤存在一定的恶变率,良性以局部切除为主,恶变则需进一步手术.

Clinical analysis of 161 cases with intraductual papillomas

Objective: To explore the diagnosis and treatment of intraductal papilloma. Method: The data of 161 cases of intraductal papilloma were analyzed retrospectively. Result: 161 patients all were female, solitary papilloma was found in 143 cases, among which 7 cases were malignant;Multiple papillomas were found in 18 cases, among which 2 cases were malignant. 41 cases underwent the cytologic examination of discharge, the results of 18(43.9%) among which were consistent with pathologic diagnosis postoperatively; 51 underwent galactography, the results of 29(56.9%) among which were consistent with pathologic diagnosis postoperatively. In our study, the patients with benign diseases underwent segmentectomy or lumpectomy, and those with malignancy underwent radical operations. No recurrence was found during the follow-up from 1 to 7 years after operation. Conclusion: Galactography and cytologic examination of the discharge are the available methods for the diagnosis of intraductal papilloma preoperatively. Papillomas have the risk of malignancy, and the benign needs local operations while the malignancy needs further operation.