关键词: 乳溢, 乳腺疾病, 纤维乳管镜, 多发隆起性病变

Abstract: Objective　To provide guidance for clinical diagnosis of patients with nipple discharge by studying the clinical features of protrusion lesions of nipple discharge patients with different amounts of protrusion lesions under breast ductoscopy.Methods　In 515 patients with nipple discharge under treatment in the Fourth Affiliated Hospital of China Medical University from July 2007 to December 2014 were selected;all patients received breast ductoscopy and protrusion lesions were observed by breast ductoscopy.Clinical features of patients with different amounts of protrusion lesions under breast ductoscopy were retrospectively analyzed,including age,discharge amount,pore number,discharge color，and grade of duct of protrusion lesions were observed by breast ductoscopy.Results　In 515 patients with nipple discharge,454 cases（88.2%） were diagnosed with single protrusion lesion and 61 cases（11.8%） were diagnosed with multiple protrusion lesions;274 cases（53.2%） were ≥45 years old and 241 cases（46.8%） were <45 years old;460 cases （89.3%） had unilateral nipple discharge and 55 cases （10.7%） had bilateral nipple discharge;420 cases （81.6%） had single-pore nipple discharge and 95 cases （18.4%） had multiple-pore nipple discharge;233 cases （45.3%） had red bloody discharge,221 cases （42.9%） had discharge of yellow serosity,47 cases （9.1%） had colorless water-like discharge and 14 cases （2.7%） had white milk-like discharge;437 cases （84.9%） had protrusion lesions on ducts below and equal to Grade 3 and 78 cases （15.1%） had protrusion lesions on ducts above Grade 3.Proportion of bilateral nipple discharge and multiple-pore nipple discharge in patients with multiple protrusion lesions were both larger than those in patients with single protrusion lesions （P<0.05）;there was no significant difference in age and discharge color between patients with single and mulliple of protrusion lesions（P>0.05）.52 cases （11.5%） of single protrusion lesions had protrusion lesions on ducts above Grade 3 under breast ductoscopy and 26 cases （42.6%） of multiple protrusion lesions had protrusion lesions on ducts above Grade 3 under breast ductoscopy;the incidence rate of protrusion lesions on ducts above Grade 3 under breast ductoscopy in patients with multiple protrusion lesions was higher than that in patients with single protrusion lesions（χ2=40.651,P<0.01）.Conclusion　Attention should be paid to clinical features of nipple discharge.When a patient is diagnosed with bilateral nipple discharge,multiple-pore nipple discharge and protrusion lesions on ducts above Grade 3 under breast ductoscopy,the patient should be informed of the possibility of multiple protrusion lesions;however age and discharge color cannot help to judge whether protrusion lesions of different amounts exist.

Key words: Galactorrhea, Breast diseases, Fiberoptic ductoscopy, Multiple apophysis lesions