Falardeau M, Legault S, Poljicak M, Péloquin A, Oliva-Ouimet D, Gravel D
Service de Chirurgie, Hôpital Notre-Dame, Montreal, Québec, Canada.
Ann Chir. 1991;45(9):796-801.
A single duct mammary discharge is a sign of an underlying disease: inflammatory, benign proliferative disease or even cancer. Selective resection of a ductolobular tree insures appropriate diagnosis and causative and definitive treatment of the discharge. Mammogram is essential. Galactography is quite usefull and reliable but may be unindicated or contraindicated. Surgery includes catheterization of the hole, methylene blue dye staining of the duct, circumareolar or radial incision, dissection, pyramidal resection of the whole galactophoric tree and closure with a retracting suture of the nipple. Woman's age, color of the discharge, pre-operative galactography suggest the diagnosis which has been in our series of 73 cases an inflammatory process in 53.4% of cases, a benign proliferative in 42.5% of cases and an epithelioma in situ in 4.1% of cases. The 46 cases of serous, serosanguinous or sanguinous discharge were due to an inflammatory process in 15 cases (32.6%), a benign proliferative in 28 cases (60.9%) and an in situ carcinoma in 3 cases (6.5%).
炎症性、良性增生性疾病甚至癌症。对导管小叶树进行选择性切除可确保对溢液进行恰当诊断以及病因和确定性治疗。乳房X线摄影至关重要。乳管造影相当有用且可靠，但可能不适用或禁忌。手术包括对溢液孔进行插管、对导管进行亚甲蓝染料染色、乳晕周围或放射状切口、解剖、对整个输乳管树进行锥形切除以及用乳头回缩缝线缝合。女性年龄、溢液颜色、术前乳管造影提示诊断结果，在我们的73例病例系列中，炎症过程占53.4%，良性增生占42.5%，原位上皮瘤占4.1%。46例浆液性、浆液血性或血性溢液病例中，15例（32.6%）是由炎症过程引起，28例（60.9%）是由良性增生引起，3例（6.5%）是由原位癌引起。
