Berger Ori, Gersh Guy, Talisman Ran
From the Department of Plastic Surgery, Barzilai University Medical Center, Ashkelon, Israel.
Plast Reconstr Surg Glob Open. 2024 May 24;12(5):e5827. doi: 10.1097/GOX.0000000000005827. eCollection 2024 May.
Nipple adenomas (NAs) are rare benign proliferative tumors presenting as palpable nodules, erosive lesions, or nipple discharge, mimicking other conditions. This systematic review categorizes cases into sole NA (ONA) or co-diagnoses with other conditions (CONA) to enhance clinical recognition, diagnosis, and treatment efficacy.
Following PRISMA guidelines, a PubMed search was conducted for NA. Inclusion criteria covered original research, excluding reviews or other breast diseases. Bias risk was assessed through a thorough search, authors independently evaluated studies, and data were synthesized using varied measures. Subgroups ONA and CONA were formed. Analyses were conducted in Excel and R, complemented by a qualitative review due to case report predominance. Biases in case reports were transparently addressed.
Of the 86 studies, 387 cases were analyzed, showing 10.34% with co-diagnoses of malignant or premalignant conditions. Mean age was 44, with a female predominance (97%). ONA (347 cases) and CONA (40 cases) subgroups exhibited variations in symptoms, physical findings, and imaging. Treatment modalities included excision (51.39%), biopsy alone (11.1%), and mastectomy (8.6%). Mean follow-up of 56.73 months revealed recurrence (2.87%) and malignancy development (1.79%), notably in CONA cases (33.33%).
This study provides insights into the broader age range of NA and its associations. Higher co-diagnosis rates were correlated with older age, highlighting the necessity for thorough investigation, with excision as the primary treatment. Follow-up emphasizes the significance of identifying and monitoring CONA cases, which pose a higher malignancy risk. Recurrence is presumed to be linked to proper lesion excision and co-diagnosis.
乳头腺瘤（NA）是罕见的良性增生性肿瘤，表现为可触及的结节、糜烂性病变或乳头溢液，易与其他病症混淆。本系统评价将病例分为单纯乳头腺瘤（ONA）或与其他病症共诊断（CONA），以提高临床识别、诊断和治疗效果。
按照PRISMA指南，在PubMed上搜索NA。纳入标准涵盖原始研究，排除综述或其他乳腺疾病。通过全面检索评估偏倚风险，作者独立评估研究，并使用多种方法综合数据。形成ONA和CONA亚组。在Excel和R中进行分析，并因病例报告占主导地位进行定性综述。透明地处理病例报告中的偏倚。
在86项研究中，分析了387例病例，显示10.34%伴有恶性或癌前病症的共诊断。平均年龄为44岁，女性占主导（97%）。ONA（347例）和CONA（40例）亚组在症状、体格检查结果和影像学方面存在差异。治疗方式包括切除（51.39%）、单纯活检（11.1%）和乳房切除术（8.6%）。平均随访56.73个月显示复发率为2.87%，恶性肿瘤发生率为1.79%，在CONA病例中尤为明显（33.33%）。
本研究提供了关于NA更广泛年龄范围及其关联的见解。较高的共诊断率与年龄较大相关，强调了彻底检查的必要性，以切除作为主要治疗方法。随访强调了识别和监测CONA病例的重要性，这些病例具有较高的恶性肿瘤风险。复发被认为与病变的适当切除和共诊断有关。
