Romero C, Lombardía J, Almenar A, Calvo P, Fandiño E, Aso S, Carreira C
Servicio de Radiología, Unidad de patología mamaria, Hospital Virgen de la Salud, Toledo, Spain.
Radiologia. 2007 Jul-Aug;49(4):255-61. doi: 10.1016/s0033-8338(07)73767-0.
To retrospectively study the diagnosis and treatment of benign breast disease during pregnancy and breastfeeding at our department. To review the relevant literature.
From January 2001 to March 2005, a total of 91 pregnant or breastfeeding women (age range: 23-36 years) were diagnosed with benign breast pathology. All patients presented with palpable nodules or inflammatory symptoms. Ultrasound-guided fine-needle cytology was performed in all cases and percutaneous core biopsy was considered necessary in three cases. Abscesses were drained when present. Patients provided their informed consent before all procedures.
Tumors were detected in 28 cases (30%): fibroadenomas (n = 12), lactating adenomas (n = 9), galactoceles (n = 5), and papillomas (n = 2). Conservative treatment with ultrasound follow-up was employed in all cases except one, which required surgical treatment in the third trimester. On 63 occasions (70%), the pathology was inflammatory, including abscesses in 24 cases (38%); abscesses were drained using fine-needle aspiration (n = 16) or pig-tail catheter (n = 3), according to protocol, depending on the size of the abscess (less than or greater than 3 cm). In 5 cases the abscesses were drained surgically.
The most common benign breast pathology during pregnancy is inflammatory and is satisfactorily managed with antibiotics and percutaneous drainage with good esthetic results. Ultrasound is the diagnostic technique of choice, together with cytology; percutaneous biopsy is only performed in uncertain cases to minimize the risk of fistulas. Management of tumors after histological confirmation should be conservative with close follow-up. These tumors cause no problems for the child, the mother, or breastfeeding.
回顾性研究我科妊娠及哺乳期良性乳腺疾病的诊断与治疗情况，并复习相关文献。
2001年1月至2005年3月，共有91例妊娠或哺乳期妇女（年龄范围：23 - 36岁）被诊断为良性乳腺病变。所有患者均表现为可触及的结节或炎症症状。所有病例均进行了超声引导下细针细胞学检查，3例认为有必要进行经皮芯针活检。如有脓肿则进行引流。所有操作前患者均签署了知情同意书。
28例（30%）检测出肿瘤：纤维腺瘤（n = 12）、哺乳期腺瘤（n = 9）、积乳囊肿（n = 5）和乳头状瘤（n = 2）。除1例在孕晚期需要手术治疗外，所有病例均采用超声随访的保守治疗。63例（70%）病理结果为炎症，其中24例（38%）为脓肿；根据方案，根据脓肿大小（小于或大于3 cm），采用细针抽吸（n = 16）或猪尾导管引流（n = 3）。5例脓肿进行了手术引流。
妊娠期间最常见的良性乳腺病变是炎症性的，使用抗生素和经皮引流可得到满意治疗，且美容效果良好。超声是首选的诊断技术，结合细胞学检查；仅在不确定的病例中进行经皮活检，以尽量减少瘘管形成的风险。组织学确诊后的肿瘤管理应采取保守治疗并密切随访。这些肿瘤对胎儿、母亲或母乳喂养均无影响。
