Ishizuka Mariko, Yamamoto Daigo, Shoji Tetsuji, Sueoka Noriko, Miyata Mami, Umezaki Nodoka, Yoshikawa Katsuhiro, Yoshida Nao, Sekimoto Hirotsugu
Dept. of Surgery, Kansai Medical University.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2339-2341.
Nipple discharge is a common symptom and frequently results from benign tumors. However, there is a 5-30% risk of malignancy. A 65-year-old woman presented at the hospital because of bloody nipple discharge in her right breast. She had noticed an abnormal nipple discharge for several months. Mammography showed focal asymmetric densities without calcification in the middle outer quadrant of her right breast. Ultrasonography indicated a 1.5×1.1 cm sized cyst with fluid-fluid level. Breast MRI showed a simple cyst with a benign contrast enhancement pattern. No malignant cells were observed by fine-needle aspiration. Considering the low sensitivity of mammography and breast MRI to DCIS, we performed an excisional biopsy. Histological examination revealed that the lesion was DCIS. The patient underwent right total mastectomy and was diagnosed with low grade DCIS(ER-positive, PgR-positive, HER2-negative). She continues endocrine therapy with an aromatase inhibitor.
乳头溢液是一种常见症状，通常由良性肿瘤引起。然而，存在5%至30%的恶变风险。一名65岁女性因右乳血性乳头溢液到医院就诊。她注意到乳头异常溢液已有数月。乳房X线摄影显示右乳中外象限有局灶性不对称密度影，无钙化。超声检查显示一个1.5×1.1厘米大小的有液-液平面的囊肿。乳腺磁共振成像显示一个具有良性对比增强模式的单纯囊肿。细针穿刺未发现恶性细胞。考虑到乳房X线摄影和乳腺磁共振成像对导管原位癌的敏感性较低，我们进行了切除活检。组织学检查显示病变为导管原位癌。患者接受了右乳全切术，被诊断为低级别导管原位癌（雌激素受体阳性、孕激素受体阳性、人表皮生长因子受体2阴性）。她继续接受芳香化酶抑制剂内分泌治疗。
