伴乳头溢液乳腺癌的乳腺导管造影表现与病理对照研究

目的:分析伴有乳头溢液乳腺癌的乳腺导管造影表现,并分析其病理基础,以提高诊断水平。方法:临床表现有乳头溢液并经手术、病理证实的乳腺癌23例,回顾性分析其乳腺导管造影的影像表现,并与手术病理结果进行对比分析。结果:23例中原位癌8例,浸润性导管癌10例(包括单纯癌6例、乳头状癌4例),导管癌早期浸润3例,乳头状瘤病恶变2例。病理上诊断早期癌13例(56.5%),其中8例临床未触及乳腺肿块。乳腺导管造影主要表现:导管内充盈缺损并伴有不同程度的导管扩张12例;乳腺肿瘤侵蚀导管形成潭湖征5例;溢液导管受乳腺肿块推挤,导管变形3例;导管持续显影、管壁不规则伴广泛微钙化灶1例。本组中乳腺导管造影诊断乳腺癌的符合率为82.6%。结论:乳腺导管造影对伴有乳头溢液乳腺癌的检出是一项安全、有效的检查方法,能准确观察到肿块与溢液导管的位置关系、溢液导管受侵蚀程度,而且还能检测出临床触诊阴性的早期乳腺癌。

Correlation of Galactography and Pathology Features in Breast Cancer with Nipple Discharge

Objective:To analyze the galactographic features in breast cancer with nipple discharge and to correlate with the pathologic findings,in order to improve the diagnostic accuracy of breast cancer.Methods:A retrospective study was performed to analyze the galactographic features and to correlate with the pathologic findings in 23 cases of breast(cancer) with nipple discharge.Results:Among the 23 cases of breast cancer with nipple discharge,the pathohistology diagnosis included 8 cases of ductal carcinoma in situ,10 cases of invasive carcinoma with invasive ductal carcinoma(n=6),papillary carcinoma(n=4),3 cases of early infiltration of ductal carcinoma and 2 cases of malignant change of benign papilloma.All together there were 13 cases with early cancer and 8 cases were non-palpable breast cancer.The galactographic features were:12 cases had lactiferous duct filling defect with various degree dilatation,5 cases had "pool-like" expansion due to encroaching and narrowing of lactiferous duct,3 cases had ductal distortion by tumor mass compression,and 1 case showed normal duct with numerous micro-calcifications.The accuracy rate of galactography in the diagnosis of breat cancer was(82.6%)(4/23).Conclusion:Galactography is a useful and safe modality in the diagnostic workup of nipple discharge of breast.Not only the relationship of tumor mass with the invaded lactiferous duct,the degree of ductal involvement,could be accurately demonstrated,but also early non-palpable carcinoma with nipple discharge could be detected.