Department of Surgery, University College of Medical Sciences and GTB Hospital, University of Delhi, Delhi 110095, India.
World J Surg. 2012 Sep;36(9):2252-8. doi: 10.1007/s00268-012-1671-4.
Benign conditions of the breast are common, but a great deal of confusion exists in their nomenclature, classification, and, treatment protocols. The Aberration of Normal Development and Involution (ANDI) classification provides a comprehensive framework within which to correlate clinical presentation with pathogenesis. Most clinical studies have not used this classification system. We studied the spectrum of benign breast conditions in Indian patients with reference to the ANDI system and performed a clinicopathologic correlation.
This prospective study was carried out on 262 consecutive patients attending the surgery department on an outpatient basis for benign breast conditions.
A total of 199 (76 %) patients had a diagnosis of benign breast disorder, and 44 (17 %) had benign breast disease. There were 19 (7 %) women with non-ANDI and other conditions. The spectrum of benign breast disorders included fibroadenoma 77, mastalgia with nodularity 98, galactocele 7, cysts 4, and nipple discharge (ND) 13. Benign breast diseases included giant/multiple fibroadenomas 18, incapacitating mastalgia and nodularity 13, subareolar abscess with mammary fistula 7, periductal mastitis with suppuration 4, and ND 2. Cytopathologic correlation performed in 115 patients showed nonproliferative disease in 82, proliferative disease without atypia in 19, proliferative disease with atypia in 3, and miscellaneous 11.
The ANDI classification is a comprehensive system that delineates the borderline between normal and abnormal, achieves correlation of clinical signs and symptoms with histologic changes, and provides risk stratification and pragmatic definition of management protocols.
乳房良性疾病较为常见，但在其命名、分类和治疗方案上存在大量混淆。异常发育和退化（ANDI）分类为将临床表现与发病机制相关联提供了一个全面的框架。大多数临床研究并未使用该分类系统。我们参考 ANDI 系统研究了印度患者的良性乳腺疾病谱，并进行了临床病理相关性分析。
本前瞻性研究对 262 例连续门诊就诊的良性乳腺疾病患者进行了研究。
共有 199 例（76%）患者诊断为良性乳腺疾病，44 例（17%）患者诊断为良性乳腺疾病。还有 19 例（7%）患者患有非 ANDI 和其他疾病。良性乳腺疾病谱包括纤维腺瘤 77 例、乳房痛伴结节 98 例、积乳囊肿 7 例、囊肿 4 例和乳头溢液（ND）13 例。良性乳腺疾病包括巨大/多发性纤维腺瘤 18 例、严重乳房痛伴结节 13 例、乳晕下脓肿伴乳瘘 7 例、导管周围乳腺炎伴化脓 4 例和 ND 2 例。对 115 例患者进行的细胞学相关性分析显示，非增生性疾病 82 例，非典型增生性增生性疾病 19 例，增生性疾病伴非典型性 3 例，其他 11 例。
ANDI 分类是一个全面的系统，它划定了正常和异常之间的界限，实现了临床症状与组织学变化的相关性，并提供了风险分层和管理方案的实用定义。
