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[乳腺纤维乳管镜下乳腺导管内病变切除术]

[Breast intraductal lesion resection under breast fiberoptic ductoscopy].

作者信息

Wu Wei, Li Xiao-rong, Yang Kai-yan, Dong Bo-ni, Chen Dao-jin

机构信息

Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2008 Jan;33(1):81-4.

Abstract

OBJECTIVE

To explore the feasibility and to sum up the experience of breast intraductal neoplasm resection under breast fiberoptic ductoscopy (FDS).

METHODS

FDS was performed on 548 patients with nipple discharge from Sep.2004 to Nov.2006. The clinical data of breast intraductal neoplasm found by FDS in patients who underwent tumor resection were analyzed, and the breast intraductal neoplasm image characteristics, diagnosis, operative type and postoperative pathological results were analyzed.

RESULTS

Of the 548 patients with nipple discharge, intraductal neoplasm was found in 187 cases (34.1%), intraductal papilloma in 159 cases (29.0%), intraductal papillomatosis in 12 cases (2.2%), and breast carcinoma in 16 cases (2.9%). One hundred thirty-five patients were operated on in our hospital, of whom 91 were performed tumor resection or segmentectomy under the localization by FDS, and the other 44 were performed segmentectomy after breast duct infusion of methylene blue. The diagnostic rate under FDS in the FDS group (97.8%) was higher than that in the breast duct infusion methylene group (86.4%) (chi2=6.96, P=0.008).

CONCLUSION

FDS is not only an accurate diagnosis for breast intraductal lesion, but also an assistance to localize the breast intraductal neoplasm and to remove them in the operation.

摘要

目的

探讨在乳腺纤维导管镜(FDS)下进行乳腺导管内肿瘤切除术的可行性并总结经验。

方法

对2004年9月至2006年11月间548例乳头溢液患者进行FDS检查。分析在接受肿瘤切除术患者中FDS发现的乳腺导管内肿瘤的临床资料,对乳腺导管内肿瘤的图像特征、诊断、手术方式及术后病理结果进行分析。

结果

548例乳头溢液患者中,发现导管内肿瘤187例(34.1%),导管内乳头状瘤159例(29.0%),导管内乳头状瘤病12例(2.2%),乳腺癌16例(2.9%)。我院对135例患者进行了手术,其中91例在FDS定位下进行肿瘤切除或区段切除术,另外44例在乳腺导管注入亚甲蓝后进行区段切除术。FDS组FDS下诊断率(97.8%)高于乳腺导管注入亚甲蓝组(86.4%)(χ2=6.96,P=0.008)。

结论

FDS不仅对乳腺导管内病变有准确诊断价值,而且有助于乳腺导管内肿瘤的术中定位及切除。

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