Devitt J E
Surg Gynecol Obstet. 1986 Apr;162(4):340-2.
Five hundred and eighty-one women over the age of 55 years with a benign disorder of the breast have been studied out of a total of 4,379 consecutive consultations for a perceived mammary problem. The relative age specific incidence of benign disorders of the breast dropped dramatically after menopause. Eighty per cent of older patients seen with these phenomena were between 55 and 69 years of age. Older women with benign disorders of the breast were more likely to have had a previous benign finding at biopsy or aspiration than younger patients. The use of hormonal supplements in these women was no different than that believed to occur in the regular population, except in the patients with cysts of the breast. The most common complaint was nodularity with or without pain. Cysts and fibroadenomas were proportionately much less common than in younger women and one-half of the patients who had cysts were taking hormonal supplements. In women more than 55 years of age, papillomas of the duct are responsible for approximately one-third of the nipple discharges, although the most common cause is ectasia of the duct. The postmenopausal involution makes the breast much easier to examine, both clinically and roentgenographically so that diagnosis of benign disorders can be made with reasonable confidence. Cysts can be safely aspirated because cystic carcinomas which do occur in this age group can be fairly easily recognized by gross clinical features.
在总共4379例因乳腺问题前来连续就诊的患者中,对581名年龄超过55岁的患有乳腺良性疾病的女性进行了研究。绝经后,乳腺良性疾病的相对年龄别发病率急剧下降。80%出现这些现象的老年患者年龄在55至69岁之间。与年轻患者相比,患有乳腺良性疾病的老年女性在活检或穿刺时更有可能曾有过良性检查结果。除了患有乳腺囊肿的患者外,这些女性使用激素补充剂的情况与普通人群中认为的情况并无不同。最常见的症状是有或无疼痛的结节。囊肿和纤维腺瘤的比例比年轻女性少得多,并且有一半患有囊肿的患者正在服用激素补充剂。在55岁以上的女性中,导管乳头状瘤约占乳头溢液的三分之一,尽管最常见的原因是导管扩张。绝经后的乳腺退化使得在临床和影像学上对乳腺进行检查都容易得多,从而能够有合理的把握做出良性疾病的诊断。囊肿可以安全地抽吸,因为在这个年龄组中确实发生的囊性癌可以通过大体临床特征相当容易地识别出来。