Karimova E Jane, Slanetz Priscilla J
Brigham and Women's Hospital, Department of Radiology, Boston, MA.
Boston University Medical Center, Department of Radiology, Boston, MA.
J Breast Imaging. 2020 Jun 3;2(3):275-284. doi: 10.1093/jbi/wbaa014.
Nipple discharge, a relatively common presenting symptom for women of all ages, may be due to both benign and malignant conditions. Men can also present with nipple discharge, and when they do, they have a higher likelihood of malignancy than women. Radiologists vary in their evaluation of patients with nipple discharge, although the American College of Radiology practice guidelines for nipple discharge provides data-driven appropriate algorithms. In patients with physiologic discharge, imaging is not typically indicated. For those with pathologic nipple discharge, imaging typically starts with diagnostic mammography and retroareolar ultrasound for women over 40 years of age, diagnostic mammogram or ultrasound for women aged 30-39 years, and ultrasound for women younger than 30 years. Finally, contrast-enhanced breast MRI or galactography are usually reserved for identifying the cause of discharge when initial imaging with mammography and ultrasound is unrevealing.
乳头溢液是各年龄段女性相对常见的症状，可能由良性和恶性疾病引起。男性也可能出现乳头溢液，而且男性出现乳头溢液时，患恶性肿瘤的可能性比女性更高。放射科医生对乳头溢液患者的评估存在差异，尽管美国放射学会关于乳头溢液的实践指南提供了基于数据的适当算法。对于生理性溢液的患者，通常不建议进行影像学检查。对于病理性乳头溢液的患者，影像学检查通常从40岁以上女性的诊断性乳腺钼靶和乳晕后超声开始，30 - 39岁女性进行诊断性乳腺钼靶或超声检查，30岁以下女性进行超声检查。最后，当乳腺钼靶和超声的初始影像学检查未发现问题时，通常会采用对比增强乳腺磁共振成像或乳管造影来确定溢液的原因。
