Clinical Study On Benign And Malignant Breast Lesions With Nipple Discharge

Objective This study was to investigate the relationship between the clinical features of pathological nipple discharge breast lesions and the nature of benign and malignant lesions and the diagnostic value of imaging examination.Methods Retrospective analysis of 331 cases of breast surgery in China-Japan Union Hospital from October 2016 to October 2018,patients with pathological nipple discharge as the first symptom were female.The clinical,imaging data and postoperative pathology of all patients were collected.The relationship between the clinical features of nipple discharge patients and benign and malignant breast lesions with nipple discharge and the diagnostic value of imaging examination were analyzed by chi-square test and multivariate logistic regression.Result A total of 331 female patients were enrolled,aged 18-72 years,with a disease duration of 1 day to 10 years.The patient's menstrual status,duration,single/double breast,single hole/porous in patients with pathological nipple discharge have no significant difference in malignancy(P>0.05).There were significant differences in age and whether there were breast lumps,calcification,and nipple discharge traits in pathological nipple discharge between benign and malignant lesions(P<0.05).Further multivariate logistic regression analysis showed whether there was a mass,age ? 50 years,and calcification was a high risk factor for breast cancer with nipple discharge(P<0.05).The malignant rate was higher in patients with calcification than in patients without calcification,and the malignant rate in patients with suspected malignant calcification was significantly higher than that without calcification or benign calcification(P<0.05).The sensitivity of mammography was 51.61%(16/31),lower than ultrasound(67.74%)and breast ductoscopy(80.65%).Sensitivity can be significantly improved in mammography combined with breast ultrasound or breast ductoscopy(51.61% vs.96.77%,51.61% vs.96.77%).Breast ultrasound combined with breast ductoscopy showed a significant increase in sensitivity(67.74% vs % 96.77).The combined diagnostic sensitivity of the three types can be as high as 98.4%.Conclusion:Age ? 50 years,with a lump,with calcification is a risk factor for pathological nipple discharge breast cancer,bloody discharge is not a risk factor;Mammography combined with breast ultrasound or breast ductoscopy,breast ultrasound combined with breast ductoscopy,and the combination of three methods have significantly improved the sensitivity of breast cancer with nipple discharge.