| Background:Periductal mastitis is a benign,chronic,and non-specific breast disease based on breast duct dilation and characterized by infiltration of plasma cells and other inflammatory cells in the surrounding breast tissue.It is more common in nonlactating women of childbearing age and belongs to a kind of non-lactating mastitis.At present,the etiology of the disease is unknown,treatment is difficult,easy to relapse,it is necessary to carry out further clinical research on this disease。Purpose:To explore the clinicopathologic features and recurrence risk factors of periductal mastitis,provide reliable evidence for clinical guidance and treatment of periductal mastitis,and screen high-risk patients with recurrence risk to provide intervention measures。Methods:Clinical data of 91 patients diagnosed with periaductal mastitis by pathological diagnosis in the First Affiliated Hospital of Nanchang University from January 2012 to October 2022 were collected and followed up.The percentage of continuous variable and categorical variable was used to describe the baseline characteristics of the clinicopathologic features and the related factors of relapse after treatment.The t test,Chi-square test and multiple logistic regression analysis were used to explore the risk factors of relapse。Results:A total of 91 patients with periaductal mastitis meeting the criteria were included,all of which were female.The mean age of onset was(39.45±11.13)years.Postmeno-pausal status: 78 cases were premenopausal and 13 cases were postmenopausal.Place of residence: urban 33 cases,rural 58 cases;Marriage and childbearing history:84 married children and 7 unmarried children.According to statistics,all patients had symptoms at the time of seeing a doctor.The first symptoms at the time of seeing a doctor were: discharge in 10 cases,breast lump in 78 cases,pain in 1 case and other symptoms in 2 cases.There were 25 cases with abscess and 66 cases without abscess,among which 7 cases were abscess with fistula.There were 53 patients with pain.There were 14 cases with nipple retraction or invagination.Among the patients,the lesion was located in the peripheral mammary gland in 40 cases.In 51 cases,the lesion was located in the central region.Breast lesions involved: unilateral 87 cases,bilateral 4 cases.Pathological type: PDM(16 cases),PCM(35 cases),MDD(40cases).On admission,81 patients had normal body temperature and 10 had fever.Blood routine and inflammatory index: abnormal 21 cases,normal 70 cases.The results of bacterial smear and culture in 25 cases were negative.There were 16 cases of periductal mastitis,35 cases of plasma cell mastitis and 40 cases of mammary duct dilatation.Among the 74 cases,14 were treated with local resection,60 were treated with enlarged resection,17 were treated with hormone or/and antibiotics,and 11 were treated with preoperative drainage.All the patients underwent preoperative color Doppler ultrasonography and 42 underwent molybdenum target examination.Treatment: Local resection was performed in 13 cases,and recurrence occurred in 1case.There were 57 cases of extended resection and 4 cases of recurrence.The total recurrence rate was 7.14%.Among the patients treated with hormone or(and)antibiotics,13 cases relapsed and 4 cases did not relapse temporarily.The recurrence rate of drug therapy was 76.47%.Surgical complications: poor incision healing in 2cases,fat liquefaction in 4 cases,suppuration in 1 case;t test and Chi-square test were used for univariate analysis of clinical basic information and disease recurrence.Age,nipple retraction or invagination,and choice of treatment were correlated with disease recurrence(P<0.05).Logistic regression model was used to account for age,nipple retraction,and treatment,and the results showed that older patients had an increased risk of disease recurrence(P<0.05);Patients with or without nipple retraction had an increased risk of disease recurrence(P<0.05),drug treated patients had an increased risk of disease recurrence compared with surgical patients(P<0.05);Age,nipple retraction or invagination,and drug therapy were all independent risk factors for recurrence after treatment of plasma cell mastitis。Conclusion:PCM usually occurs in married women of childbearing age,and its clinical manifestations are mainly unilateral breast mass without specific manifestations.Clinical manifestations and imaging findings are easily confused with inflammatory breast cancer and other breast diseases.The positive rate of pathogenic microorganism detection was low in clinical practice.Tissue biopsy is the gold standard for diagnosing PCM.At present,the treatment of PCM mainly consists of drug therapy and surgical treatment,among which the effect of drug therapy is poor,the recurrence rate of surgical treatment is low,and the postoperative aesthetic effect needs to be further evaluated.This study found statistically significant differences in age,nipple retraction and treatment choice(P<0.05).Logistic regression model included multiple variables such as age,nipple retraction and treatment,and the results showed that 1.Older patients had an increased risk of disease recurrence(P<0.05);Patients with nipple retraction had an increased risk of disease recurrence compared to patients without nipple retraction(P<0.05);3.Patients treated with drugs had an increased risk of disease recurrence compared with patients treated with surgery(P<0.05)... |
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