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纤维乳管镜在病理性乳头溢液患者管理中的应用:波兰单中心经验。

Use of fiberoductoscopy for the management of patients with pathological nipple discharge: experience of a single center in Poland.

机构信息

Department of Surgical Oncology, Medical University of Gdansk, Smoluchowski Str 17, 80-214, Gdansk, Poland.

Department of Cardiac Surgery, Children's Health Memorial Institute, Warsaw, Poland.

出版信息

Breast Cancer. 2018 Nov;25(6):753-758. doi: 10.1007/s12282-018-0883-3. Epub 2018 Jun 25.

Abstract

BACKGROUND

Pathological nipple discharge (PND) is associated with serious clinical and diagnostic issues. Fiberoductoscopy (FDS) is a new diagnostic option in PND patients. This study summarizes our initial experience of FDS for the management of PND patients in a single center in Poland and assesses its safety.

METHODS

A total of 256 women with PND were included in this prospective, case-controlled, single-center study between 2006 and 2014. Of the 250 patients who underwent FDS, 154 had mammary duct lesions and 96 had no visible lesions. Subsequently, 129 patients with lesions identified by FDS underwent microductectomy and the lesions were pathologically evaluated.

RESULTS

The mean duration of FDS examination was 17 min. The most frequent intraductal lesion was amputation of a duct (35.1%), followed by circular narrowing or hyperplasia (22.7%). Final histological findings were unremarkable in 11.6% of cases, whereas mammary duct papilloma, duct ectasia, and ductal carcinoma in situ were detected in 71.3, 10.9, and 6.2% of cases, respectively.

CONCLUSIONS

FDS is an innovative method for visualizing intraductal mammary lesions and allows accurate selection of mammary ducts with suspicious lesions that require surgical removal in women with PND.

摘要

背景

病理性乳头溢液(PND)与严重的临床和诊断问题有关。纤维乳管镜检查(FDS)是 PND 患者的一种新的诊断选择。本研究总结了我们在波兰的一家单中心对 PND 患者使用 FDS 的初步经验,并评估了其安全性。

方法

2006 年至 2014 年间,我们进行了一项前瞻性、病例对照、单中心研究,共纳入 256 例 PND 女性患者。在 250 例行 FDS 的患者中,154 例有乳腺导管病变,96 例无可见病变。随后,129 例 FDS 发现病变的患者接受了微乳管切除术,并对病变进行了病理评估。

结果

FDS 检查的平均持续时间为 17 分钟。最常见的管内病变是导管截断(35.1%),其次是环状狭窄或增生(22.7%)。最终的组织学发现 11.6%的病例无明显异常,而乳腺导管乳头状瘤、导管扩张和导管原位癌分别在 71.3%、10.9%和 6.2%的病例中发现。

结论

FDS 是一种可视化乳腺管内病变的创新方法,可准确选择需要手术切除的可疑病变的乳腺管,适用于 PND 患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8bf/6208849/b24bb9a5be89/12282_2018_883_Fig1_HTML.jpg

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