Department of Pathology, University of Health Sciences Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey.
Department of General Surgery, University of Health Sciences Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey.
Arch Iran Med. 2022 Nov 1;25(11):748-754. doi: 10.34172/aim.2022.118.
Nipple discharge is a common finding which may be a symptom of breast cancer, but it is mostly caused by benign causes. A surgical biopsy followed by a histopathological examination is considered to be the gold standard for the diagnosis of pathological nipple discharge. Non-surgical diagnostic methods should be considered to reduce the need for intervention. Ductal lavage cytology (DLC) is performed by washing and examining the ductal discharge. The usefulness of examining spontaneous discharge is controversial. This study's aim is to evaluate the usefulness in surgical decision-making of ultrasonography (USG), mammography (MMG), magnetic resonance imaging (MRI), ductography, and DLC in patients with pathological nipple discharge.
Between 2011 and 2018, we retrospectively analyzed 141 patients with pathological nipple discharge who were planned to undergo a surgical procedure and were found to have pathology. In our study, the diagnostic efficiency of DLC for breast cancer diagnosis was compared with USG, MMG, MRI, and ductography.
USG was performed in all patients, MMG in 51, MRI in 56, ductography in 46 patients, and cytological samples were taken from 63 patients. Twelve of 17 patients with malignant pathology were reported cytologically as suspected malignancy. The sensitivity of DLC was 70.5% (95% CI: 0.489-0.922), and its specificity was 94.1% (95% CI: 0.862-1.020).
Numerous studies report that cytology is not adequate for final diagnosis. Negative cytology does not exclude the possibility of malignancy, and positive results do not help in the differential diagnosis.
乳头溢液是一种常见的表现，可能是乳腺癌的症状，但大多由良性原因引起。手术活检加组织病理学检查被认为是病理性乳头溢液诊断的金标准。为了减少干预的需要，应考虑非手术诊断方法。乳管冲洗细胞学（DLC）通过冲洗和检查乳管分泌物来进行。检查自发性溢液的有用性存在争议。本研究旨在评估超声（USG）、乳房 X 线照相术（MMG）、磁共振成像（MRI）、乳管造影术和 DLC 在病理性乳头溢液患者中的手术决策中的有用性。
在 2011 年至 2018 年间，我们回顾性分析了 141 例计划接受手术治疗且病理证实存在病理性乳头溢液的患者。在我们的研究中，比较了 DLC 对乳腺癌诊断的诊断效率与 USG、MMG、MRI 和乳管造影术。
所有患者均行 USG 检查，51 例行 MMG 检查，56 例行 MRI 检查，46 例行乳管造影术，63 例患者取细胞学样本。17 例恶性病理患者中有 12 例细胞学报告为可疑恶性。DLC 的敏感性为 70.5%（95%CI：0.489-0.922），特异性为 94.1%（95%CI：0.862-1.020）。
许多研究报告称细胞学检查不足以进行最终诊断。细胞学阴性并不能排除恶性肿瘤的可能性，阳性结果也无助于鉴别诊断。
