乳腺导管造影在溢液性乳腺癌诊断中的应用

目的：探讨不同病理类型的溢液性乳腺癌在乳腺导管造影中的X线征象,提高对本病的诊断水平。方法：搜集经手术病理证实并行乳腺X线片及腺导管造影检查的乳腺癌108例,溢液性质为血性62例,浆液46例,临床因溢液而疑及乳腺癌。分析不同病理类型乳腺癌（浸润性导管癌64例,浸润性小叶癌23例,其他21例包括髓样癌7例,化生性癌1例,富于脂质癌2例,导管原位癌7例,粘液癌1例,浸润性乳头状癌3例）在乳腺导管造影中的X线征象。结果：乳腺癌导管造影主要征象：鼠尾征13例,导管走行僵直16例,充盈缺损（杯口征）7例,导管扩张99例,截断征（刀切征）24例,导管结构紊乱60例,断续征37例,虫蚀样改变30例,潭湖征32例。108例乳腺癌中有106例合并两种以上征象。浸润性导管癌最多见,64例,占50%;其次为浸润性小叶癌,23例,占21.3%。结论：充分认识溢液性乳腺癌的乳腺导管造影征象,对进一步明确乳腺癌的诊断具有重要价值,合并征象越多,对乳腺癌的诊断价值越高。

Application of galactography in the diagnosis of breast cancer with nipple discharge

Objective：To study the galactography features of various pathology subtypes of breast carcinoma with nipple discharge,in order to improve the diagnosis accuracy.Methods：The mammography and galactography materials of 108 patients with surgery and pathology proved breast cancer were collected,including patients with bloody discharge（62 cases） and serous discharge（46 cases）.The galactography features of different pathology subtypes of breast carcinoma（including infiltrative ductal carcinoma（64 cases,50%）;infiltrative lobular carcinoma（23 cases,21.3%）;miscelleneous 21 cases（medullary carcinoma,7 cases;ductal carcinoma in situ,7 cases;infiltrative papillary carcinoma,7 cases;lipotrophic carcinoma,2 cases;metaplastic carcinoma and mucinous carcinoma for 1 case each） were retrospectively analyzed.Results：Main galactography features were rat-tail sign（13 cases）,rigidity of galactoducts（16 cases）;filling defect（7 cases）;ductal ectasia（99 cases）;cut-off sign（24 cases）;disorder of ductal structure（60 cases）;ductal interruption（37 cases）;wormy erosion of ducts（30 cases） and pond lake sign（32 cases）.Of the 108 patients,106 patients showed two or more above-mentioned abnormalities.Conclusion：Fully understanding of the galactography findings of breast carcinoma with nipple discharge provides significant value in the diagnosis of breast cancer.The more the abnormal findings displayed the higher the diagnostic accuracy.