Clinical Characteristics,Diagnosis And Treatment Of Mammary Duct Ectasia

Part I Retrospective analysis of clinical features of mammary duct ectasiaObjective:To analyze the history,clinical manifestation and auxiliary examination results of mammary ductal ectasia(MDE),to explore the etiology,clinical features,treatment and similarities and differences between granulomatous lobular mastitis(GLM).Methods:Retrospective analysis of July 2009 to January 2017 in Shandong University Qilu Hospital for surgical treatment,postoperative pathological diagnosis of mammary ductal ectasia and granulomatous lobular mastitis inpatient clinical data.Results:July 2009 to January 2017 in Shandong University Qilu Hospital for surgical treatment,postoperative pathology diagnosis of mammary ductal ectasia inpatients in 450 patients(90.9%),postoperative pathology diagnosis of granulomatous lobular mastitis Of the hospitalized patients were 33(6.7%),postoperative pathological diagnosis of mammary ductal ectasia with granulomatous lobular mastitis in hospital patients were 12(2.4%).In the MDE group,444(98.7%)patients were females and 6 patients were males(1.3%).MDE patients are mainly 25-36 years old,mainly for the growth period of women(469 cases,96.3%),mostly fertile(407 cases,90.4%).The mean body mass index(BMI)was 25.16,higher than the normal range(18.5-24).The main symptoms were mass,the common symptoms were breast pain,skin redness,abscess formation,skin fistula formation,ipsilateral axillary lymph nodes,fever,skin adhesion.251 cases(55.8%)in MDE group have nipple inversion.The number of white blood cells,neutrophil count,nuclear cell count,platelet count,PRL,ESR,IgG antibody,IgGl,IgG4 were higher than normal,lymphocyte count,C3 lower than normal value.Preoperative 251 patients had given antibiotic treatment,only 119 patients with symptom relief.In MDE group 28 patients were diagnosed with breast cancer,19 cases were diagnosed with fibroadenoma,18 cases were diagnosed with intraductal papilloma,37 cases were not given a clear diagnosis.Patients were hospitalized after surgery were treated,of which 34 cases of breast lump resecti on,135 cases of breast lobectomy or segment resection,265 cases of breast subcutaneous subtotal mastectomy or subcutaneous mastectomy,16 cases of mastectomy.Compared with the GLM group and the combined group,the incidence of skin ulceration was lower in the MDE group than in the GLM group and the combined group,and the rest was no statistically significant.Conclusion:MDE is common in women of childbearing age.Endocrine disorders,bacterial infections,history of breast trauma,obesity,immune factors are associated with its incidence.Patients often touch the breast mass,mass located in the areola area.Although MDE is a group of benign diseases,but the effect of antibiotic treatment is not good,many times after surgery is still easy to relapse,abscess ulceration of the formation of sinus,fistula or ulcers,seriously affecting the quality of life of patients.MDE often accompanied by axillary lymphadenopathy,and mass stage MDE breast examination and breast ultrasonography are similar to breast cancer in performance,therefore,without pathological diagnosis of the premise of direct mastectomy.MDE and GLM pathology is the standard to identify MDE and GLM,GLM compared to MDE is more prone to ulceration.Surgery is the preferred treatment of MDE,the specific scope of surgery should be based on the patient's condition and postoperative impact on breast shape,the doctor should choose the appropriate surgery.Part II Measurement and analysis of breast shape in young womenObjective:The relationship between body height,body weight,menstrual history,body circumference and breast shape was analyzed,and the distribution of breast type and its influencing factors were analyzed.Data were collected to provide data for breast surgery and breast reshaping and reconstruction.Methods:341 cases of healthy young people Female volunteers conducted a questionnaire survey to obtain general information on breast shape measurement related data and analyzed.Results:A total of 341 healthy women were divided into six groups:the flat group,the disc group,the hemisphere group,the conical group,the oblique group and the drooping group.The proportion of the conical breast was the highest,accounting for 32%.Followed by the disc group,accounting for 26.1%.Weight,BMI,waist circumference,hip circumference,triceps skinfold thickness,abdominal wall skinfold thickness,sternum-breast distance,clavicle-breast distance,breast-sternum distance,sternum length,nipple width,breast base diameter,breast medial diameter,breast lateral diameter,the distance from nipple to fold of breast,the thickness of the fat,the glands and the margins of the glands were statistically different in the six groups.And the mean values were flat group<disc group<hemisphere group<conical group<oblique group<droop group.Conclusion:Breast shape and body weight,BMI,waist circumference,hip circumference,triceps skin skin fold thickness and abdominal wall skinfold thickness was significantly related to the breast glands and fat distribution determines the breast size and shape.Breast linear measurement and gland fat thickness of different tips,we understand and clarify the different breast shape and fat gland distribution of the important significance,help to develop individualized surgical program,get better breast surgery and plastic surgery.