Clinicopathologic Features And Prognosis Of Intraductal Papilloma Of Breast And Its Coexisting Lesions

Background:In recent years,as women’s emphasis on breast health and national cancer screening project,not only improves the detection rate of early breast cancer,but also makes many to the discovery of breast benign diseases,including intraductal papilloma(intraductal papilloma,IP)is a common benign tumor of the breast,the clinical manifestations of lack of specificity,and can be characterized by nipple discharge,also can show the breast lumps,some patients clinical manifestation conceals,no obvious positive signs.Compared with other benign breast diseases,IP has the risk of relapse and malignant transformation.In addition to the typical papillary structure,IP can also be associated with different degrees of epithelial and stromal hyperplasia,and can coexist with benign lesions,atypical hyperplasia and malignant lesions.The presence of coexisting lesions will make the lesions present an abnormally complex diversity,making pathological diagnosis more difficult.Therefore,IP is a disease with complicated clinical manifestations and pathology,and the treatment plan and postoperative follow-up plan will also be different depending on the coexisting lesion of IP.Objective:The purpose of this study was to investigate the clinicopathologic features and prognostic factors of intraductal papilloma of the breast and its coexisting lesions.Methods:The clinicopathological data of 635 IP patients admitted to the department of mammary gland of our hospital on January 1,2015 and December 31,2019 were collected and followed up.They were divided into three groups according to different coexisting lesions.Group A were patients with simple IP and coexisting with benign lesions.The patients in group B were those with IP and atypical hyperplasia.In group C,patients with IP coexisted with malignant lesions.The clinical,pathological and follow-up data of the three groups were analyzed retrospectively.Results:1.Comparison of clinicopathological data of patients in the three groups showed that there were statistically significant differences in age,menstrual status,hysterectomy history,maximum lesion diameter and clinical manifestations among IP patients in the three groups(P < 0.05).2.Logistic regression analysis of the above statistically significant factors showed that age,maximum lesion diameter ≥2cm,clinical manifestations of mass or both mass and nipple discharge,and previous hysterectomy for uterine fibroids were serious risk factors for IP coexisting lesions.3.There were no significant differences in the way of lesion discovery,the time between discovery and operation,and the family history of breast among the three groups(P > 0.05).4.The difference in prognosis among the three groups was statistically significant.Patients in groups C and B had higher risk of recurrence and canceration than patients in group A(12.07%,10.53% VS 2.04%).Different IP coexisting lesions were independent factors affecting the prognosis of patients.Conclusion:1.Older patients with lesions larger than 2cm in size,a history of hysterectomy,clinical presentation of a mass,or both a mass and nipple discharge are at increased risk of severe IP coexisting lesions.2.The difference of co-existing lesions is an independent factor affecting the prognosis of IP.Compared with patients with IP alone and patients with IP and benign lesions,IP patients with atypical hyperplasia and malignant lesions have higher risk of recurrence and cancer.