Oh Jeongeum, Park Ji Yeon
Department of Radiology, Inje University Ilsan Paik Hospital, Goyang 10380, Republic of Korea.
Diagnostics (Basel). 2023 Feb 24;13(5):878. doi: 10.3390/diagnostics13050878.
No studies have evaluated whether any clinicopathological or imaging characteristics of breast papillary lesions are associated with pathological nipple discharge (PND). We analyzed 301 surgically confirmed papillary breast lesions diagnosed between January 2012 and June 2022. We evaluated clinical (age of patient, size of lesion, pathologic nipple discharge, palpability, personal/family history of breast cancer or papillary lesion, location, multiplicity, and bilaterality) and imaging characteristics (Breast Imaging Reporting and Data System (BI-RADS), sonographic, and mammographic findings) and compared malignant versus non-malignant lesions and papillary lesions with versus without PND. The malignant group was significantly older than the non-malignant group ( < 0.001). Those in the malignant group were more palpable and larger ( < 0.001). Family history of cancer and peripheral location in the malignant group were more frequent than in the non-malignant group ( = 0.022 and < 0.001). The malignant group showed higher BI-RADS, irregular shape, complex cystic and solid echo pattern, posterior enhancement on ultrasound (US), fatty breasts, visibility, and mass type on mammography ( < 0.001, 0.003, 0.009, <0.001, <0.001, <0.001, and 0.01, respectively). On multivariate logistic regression analysis, peripheral location, palpability, and age of ≥50 years were factors significantly associated with malignancy (OR: 4.125, 3.556, and 3.390, respectively; = 0.004, 0.034, and 0.011, respectively). Central location, intraductal nature, hyper/isoechoic pattern, and ductal change were more frequent in the PND group ( = 0.003, < 0.001, < 0.001, and < 0.001, respectively). Ductal change was significantly associated with PND on multivariate analysis (OR, 5.083; = 0.029). Our findings will help clinicians examine patients with PND and breast papillary lesions more effectively.
尚无研究评估乳腺乳头状病变的任何临床病理或影像学特征是否与病理性乳头溢液（PND）相关。我们分析了2012年1月至2022年6月期间手术确诊的301例乳腺乳头状病变。我们评估了临床特征（患者年龄、病变大小、病理性乳头溢液、可触及性、个人/家族乳腺癌或乳头状病变史、位置、多灶性和双侧性）和影像学特征（乳腺影像报告和数据系统（BI-RADS）、超声和乳腺X线摄影结果），并比较了恶性与非恶性病变以及有与无PND的乳头状病变。恶性组患者年龄显著大于非恶性组（<0.001）。恶性组病变更易触及且更大（<0.001）。恶性组的癌症家族史和外周位置比非恶性组更常见（分别为=0.022和<0.001）。恶性组在BI-RADS、不规则形状、复杂囊实性回声模式、超声（US）后增强、脂肪型乳腺、可见性以及乳腺X线摄影的肿块类型方面表现更高（分别为<0.001、0.003、0.009、<0.001、<0.001、<0.001和0.01）。多因素逻辑回归分析显示，外周位置、可触及性以及年龄≥50岁是与恶性肿瘤显著相关的因素（OR分别为4.125、3.556和3.390；分别为=0.004、0.034和0.011）。PND组中央位置、导管内性质、高/等回声模式和导管改变更为常见（分别为=0.003、<0.001、<0.001和<0.001）。多因素分析显示导管改变与PND显著相关（OR，5.083；=0.029）。我们的研究结果将有助于临床医生更有效地检查患有PND和乳腺乳头状病变的患者。
