Li George Z, Wong Stephanie M, Lester Susan, Nakhlis Faina
Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Breast J. 2018 Jul;24(4):624-627. doi: 10.1111/tbj.13018. Epub 2018 Mar 8.
Most pathologic nipple discharge (PND) is benign, but duct excision has been advised to exclude malignancy. To identify factors associated with malignancy, we reviewed 280 patients with PND at our institution from 2004 to 2014. In 49 cases, malignancy was found. These patients more often had palpable masses (39% vs 11%, P < .001) and abnormal imaging (94% vs 75%, P = .004). On multivariable analysis, age, palpable mass, and abnormal imaging were independently associated with malignancy. Among 48 patients with PND but no other clinical/imaging abnormalities, only 1 malignancy, a small ductal carcinoma in situ, was identified. Observation may be reasonable for these select patients.
大多数病理性乳头溢液（PND）是良性的，但仍建议进行导管切除术以排除恶性肿瘤。为了确定与恶性肿瘤相关的因素，我们回顾了2004年至2014年在我们机构就诊的280例PND患者。其中49例发现有恶性肿瘤。这些患者更常可触及肿块（39%对11%，P<0.001）和影像学异常（94%对75%，P=0.004）。多变量分析显示，年龄、可触及肿块和影像学异常与恶性肿瘤独立相关。在48例PND患者中，但无其他临床/影像学异常，仅发现1例恶性肿瘤，为小灶性导管原位癌。对于这些特定患者，观察可能是合理的。
