Ito Y, Tamaki Y, Nakano Y, Kobayashi T, Takeda T, Wakasugi E, Miyashiro I, Komoike Y, Miyazaki M, Nakayama T, Kano T, Monden M
Department of Surgery II, Osaka University Medical School, Japan.
Anticancer Res. 1997 Jan-Feb;17(1B):791-4.
In this study, 26 cases of nonpalpable breast cancer with nipple discharge treated at our department were reviewed. Their discharge was either bloody or serous with a positive hematest, but all except for one were negative for cytology, while CEA value of the discharge was high in 72.7%. Mammograms were found to be unreliable for diagnosis, while abnormal findings were observed in 84.6% by ductography. However, final diagnosis was determined histopathologically from surgical specimens, showing 14 intraductal and 12 invasive ductal cancers, none with components of comedo carcinomas. Seventeen patients underwent mastectomy following duct-lobular segmentectomy and a small remnant of intraductal carcinoma was found microscopically in only one patient. All patients except for one have survived for 98 months on average with no symptoms of metastasis. These findings suggest that duct-lobular segmentectomy with an adequate surgical margin should be adopted as the final operation for selected patients with nonpalpable breast cancer involving nipple discharge.
本研究回顾了我院收治的26例伴有乳头溢液的不可触及性乳腺癌病例。其溢液为血性或浆液性，潜血试验阳性，但除1例之外，其余细胞学检查均为阴性，而溢液的癌胚抗原（CEA）值72.7% 偏高。乳房X线摄影检查发现对诊断不可靠，而导管造影检查有异常发现者占84.6%。然而，最终诊断是通过手术标本的组织病理学检查确定的，结果显示有14例导管内癌和12例浸润性导管癌，均无粉刺癌成分。17例患者在进行小叶段切除术后接受了乳房切除术，仅1例患者在显微镜下发现有小灶残留导管内癌。除1例患者外，所有患者平均存活98个月，无转移症状。这些结果表明，对于选定的伴有乳头溢液的不可触及性乳腺癌患者，应采用具有足够手术切缘的小叶段切除术作为最终手术方式。
