Bock K, Duda V F, Hadji P, Iwinska-Zelder J, Ramaswamy A, Schmidt S, Schulz K D
Universitäts-Frauenklinik, 35033 Marburg, Germany.
Ultraschall Med. 2001 Aug;22(4):176-81. doi: 10.1055/s-2001-16813.
Lactating adenoma are circumscribed benign breast lesions developing during pregnancy or lactation due to overall enhanced proliferation of steroid hormone dependent tissue. Sonography is the method of choice for imaging mainly because of the physiologically dense breast tissue. Which is the predictive value of sonography in the diagnosis of lactating adenoma? Are sonographic characteristics dependent on age of gestation or time of lactation? Which diagnostic procedure should be recommended?
We report the long time course of four patients with histologically proven (core-needle biopsy, 16 Gauge) lactating adenoma, first diagnosed during pregnancy, which were followed up sonographically (1997-2000) with real-time B-mode, panorama-mode (Siescape) and colour-sonography.
Demonstrating a high inter- and intraindividual variability the tumors were biggest around parturitation. Despite ongoing lactation tumors regressed in size, but did not vanish completely even after definite termination of breast feeding. Evaluation of sonographical characteristics did not allow to rule out malignancy.
Three percent of all breast cancers at childbearing age coincide with pregnancy and lactation, therefore, an early histologic diagnosis is absolutely necessary. Sonographically guided core-needle biopsies allow to exclude malignancy without negative effects on breast feeding.
哺乳期腺瘤是在妊娠或哺乳期出现的边界清晰的良性乳腺病变，是由于类固醇激素依赖组织的整体增殖增强所致。超声检查是主要的成像方法，这主要是因为乳腺组织在生理上较为致密。超声检查在哺乳期腺瘤诊断中的预测价值如何？超声特征是否取决于妊娠年龄或哺乳时间？应推荐哪种诊断程序？
我们报告了4例经组织学证实（16G粗针活检）的哺乳期腺瘤患者的长期病程，这些患者首次诊断于妊娠期，并在1997年至2000年期间通过实时B超、全景模式（Siescape）和彩色超声进行超声随访。
肿瘤在个体间和个体内显示出高度变异性，在分娩前后最大。尽管持续哺乳，肿瘤大小仍有所缩小，但即使在完全停止哺乳后也未完全消失。对超声特征的评估无法排除恶性肿瘤。
育龄期所有乳腺癌中有3%与妊娠和哺乳同时发生，因此，早期组织学诊断绝对必要。超声引导下的粗针活检可以排除恶性肿瘤，且对哺乳没有负面影响。
