The Clinical Research On Mammary Galactography For Differential Diagnosis Of Nipple Discharge

Backgrounds:Nipple discharge is a common complain among women breast disease, it is the second clinical symptoms among surgery patients. Nipple discharge can divide into physiological nipple discharge and pathological nipple discharge. Physiological nipple discharge is usually bilateral, colorless and multiple ducts. Pathological nipple discharge is generally unilateral, uniductal, bloody. spontaneously and mainly caused by intraductal papilloma, ductal ectasia, papillomatosis and so on. However 5-15% of pathological nipple discharge was caused by breast maniglant disease. In this paper, all the nipple discharge was consider to be pathological nipple discharge. With acknowledge of breast carcinoma, people increasingly concerned with the pathological nipple discharge wheather caused by carcinoma or not. The etiology of Nipple discharge is not clear, there is no accepted examination method which can differential diagnose benign and malignancy of nipple discharge. Although galactography is a fundamental technique for detection and location of intraductal abnormalities, the use of galactography is still a subject of controversy. The purpose of this study was to evaluate mammary galactography to benign and malignancy differential diagnosis.Objective:By analyzing the X-ray signs of galactography to evaluate the use of mammary galactography for benign and malignancy differential diagnosis.Methods:The retrospective study used the dates from Qilu Hospital on patients who were evaluated with galactography and underwent excisional biopsy between January2014 to December 2015. The criteria for exclusion were the male patients, the failures of galactography and Obvious signs of malignant on mammography. The proferssors were unaware of each patient’s histopathological diagnosis. The results of galactography were classified as the signs of the trunk 、 the defected filling and the tree. The pathologic results were classified as the benign disease (Ductal ectisia, intraductal papilloma and papillomatosis), high-risk disease (Atypical hyperplasia and atypical intraductal papilloma)and the malignant disease (Invasive breast cancer, intraductal carcinoma, solid papillary carcinoma and so on). Analysis was performed using SPSS statistical software and GraphPad Prism 5 drawing software. Significance was set at P＜0.05.Results:1. The most commonly seen is a benign dieases, identified in up to 68.32% of cases of pathologic nipple discharge. The high-risk disease is another common cause of pathologic discharge, seen in approximately 7.45% of cases. Malignancy is found in only22.42% of cases of pathologic nipple discharge.2. The signs of the trunk is appeared at 74.36% breast malignant patinents. The percent of the signs of tree and filling defect is up to 90% in benign lesions, The classification of galactography may be use to diagnose the benign and malignancy lesions (X2=62.400, P<0.000).3. The average age of malignant disease is greater than the high-risk and benign diseases. Age of onset of mammary carcinoma more than 50 years is no statistically significant(A2=3.548, P<0.189)4. The incidence of the two sides is the same. The number of ducts for nipple discharge is statistically significant (X2=6.487, P=0.050)5. The color of discharge is not tend to be malignant disease (X2=7.432, P<0.224)6. The nipple discharge patients with the mass tend to be the malignant Disease. (X2=32.588, P<0.000)7. The cytological examination can be use to differential diagnose of nipple discharge (X2=24.400, P<0.000)Conclusions:1. Galactography can be use to differential diagnose benign and malignancy lesisons. The signs of the trunk which mainly in breast carcinoma. The signs of the tree and filling defect which happears mainly in begin disease.2. Pathological nipple discharge is mainly caused by benign dieases but 22.42% of nipple discharge was caused by breast carcinoma.3. The nipple discharge colors do not predict malignant diseases.4. The nipple discharge patients with the mass tend to be the malignant diseases.5. The cytological examination can be use to differential diagnose of nipple discharge with high specificity, but lower sensitivity.