ABSTRACT
Objective: To evaluate a not yet described ultrasound finding, the dilation of the intra-papillary portion of the lactiferous duct in patients with or without abnormal nipple discharge Methods: 24 patients with pathological nipple discharge and intrapapillary duct dilation and 1,255 asymptomatic patients (control group) were studied. Results: Just one asymptomatic patient had intrapapillary duct dilation. Among the symptomatic patients, 19 were biopsied: ten with exclusively percutaneous approach, six with exclusively surgical approach, and three with an initial percutaneous and then a surgical approach. There was one invasive carcinoma and two carcinomas in situ (15.8% of the biopsied patients). In 11 patients, a papilloma was found, three of them with atypia. In one patient, ultrasonography identified intrapapillary extension of microcalcifications, and another patient a changed duct diametrically opposite to the duct which had a trigger point. In these two patients, the examination changed the treatment strategy. In two other patients, an extra-papillary finding was identified only after the intrapapillary duct dilation has been encountered. Conclusion: The intrapapillary duct dilation is a new ultrasonography sign that adds sensitivity to the evaluation of the patient with pathological nipple discharge, besides helping to find the lesion and to guide the treatment. Further research is needed to determine its prevalence and its positive and negative predictive values for cancer, atypia and papilloma
Objetivo: Avaliar um achado de ultrassonografia inédito (dilatação intrapapilar do duto lactífero) em pacientes portadoras de fluxo papilar patológico e em pacientes assintomáticas. Métodos: Foram estudadas 24 portadoras de fluxo papilar patológico e dilatação ductal intrapapilar e 1.255 pacientes assintomáticas (grupo controle). Resultados: Apenas uma paciente assintomática apresentou dilatação ductal intrapapilar. Entre as pacientes sintomáticas, 19 foram biopsiadas, 10 com abordagem exclusivamente percutânea, 6 com abordagem exclusivamente cirúrgica e 3 com abordagem inicialmente percutânea e depois cirúrgica. Houve um carcinoma invasor e dois carcinomas in situ (15,8% das pacientes biopsiadas). Em 11 pacientes foi encontrado papiloma, 3 deles com atipias. Em uma paciente a ultrassonografia identificou extensão intrapapilar de microcalcificações e em outra, um duto alterado diametralmente oposto ao duto com sinal do gatilho clínico. Nessas duas pacientes o exame mudou a estratégia de tratamento. Em duas pacientes, um achado extrapapilar só foi identificado após o encontro da dilatação ductal intrapapilar. Conclusão: A dilatação ductal intrapapilar é novo sinal ultrassonográfico que agrega sensibilidade à avaliação da paciente com fluxo papilar patológico, além de ajudar a encontrar a lesão e a orientar o tratamento. São necessárias pesquisas adicionais para determinar sua prevalência e seus valores preditivos positivo e negativo para câncer, atipias e papilomas.
ABSTRACT
Introducción: La telorragia es un síntoma poco frecuente en pacientes pediátricos, la causa más frecuente en esta población es la ectasia ductal mamaria (EDM), que es una afección benigna y autolimitada, caracterizada por la dilatación del conducto mamario, fibrosis e inflamación periductal. Objetivo: Presentar un caso de EDM, para facilitar el rápido reconocimiento por parte de los médicos, y evitar estudios y tratamientos agresivos. Caso clínico: Lactante de sexo masculino de 6 meses de edad, sano, alimentado por lactancia materna exclusiva; consultó por un nódulo retroareolar derecho y telorragia unilateral. Se realizó una ecografía Doppler que mostró una lesión multiquística, sugerente de una EDM. Se planteó tratamiento expectante y acudió a control a los 6 meses con excelente evolución. Conclusiones: La EDM es la principal causa de telorragia en niños, corresponde a una afección benigna, y la resolución generalmente es espontánea, antes de los 9 meses. Por lo que su conocimiento es de gran relevancia para el adecuado diagnóstico y manejo de estos pacientes.
Introduction: Bloody nipple discharge is an infrequent symptom during childhood. The most common cause in this population is mammary duct ectasia (MDE), which is a benign and self-limiting condition, that is characterized by dilatation of the mammary ducts, fibrosis and periductal inflammation. Objective: Report of a case of MDE in order to improve physicians’ diagnosis accuracy and avoid aggressive studies and treatments. Case report: Six-months old male healthy infant, exclusively breastfeeded, that visited our clinic with a lump beneath his right nipple and bloody discharge from the same nipple. An ultrasound was performed which showed a multicystic lesion suggestive of MDE. Watchful waiting was decided as treatment, with good evolution after six months of follow up. Conclusions: The MDE is the leading cause of bloody discharge in pediatric population, being a benign condition that resolves spontaneously before nine months. The knowledge of this condition is essential so as to accurately diagnose and treat it.
Subject(s)
Humans , Cations/chemistry , Indicators and Reagents/chemistry , Lipids/chemistry , Polyenes/chemistry , RNA, Small Interfering/chemistry , Cell Line, Tumor , Chemistry, Pharmaceutical/methods , Gene Transfer Techniques , Genetic Vectors/genetics , HeLa Cells , Liposomes/chemistry , Luciferases/chemistry , Phospholipids/chemistry , RNA, Small Interfering/genetics , Transfection/methodsABSTRACT
Bloody nipple discharge very rarely occurs in infants and often is associated with benign mammary duct ectasia. Just because it is a rare symptom and frequently associated with adults’ mammary cancer, it is inadequately managed: inappropriate diagnostic tools are used, consequently inappropriate treatments are given. We here describe four cases of bloody nipple discharge, which resolved spontaneously within a few weeks of diagnosis and we present a review of the literature. In conclusion, a “wait and see” approach is enough and avoids unnecessary invasive diagnostic procedures.
ABSTRACT
Plasma cell mastitis,also known as periductal mastitis or mammary duct ectasia,always occurs in young women.Because of It's Complicated and varied clinical manifestations,it is easily misdiagnosed as breast cancer.Early diagnosis and staging helps to avoid unnecessary surgery.At present,There is no unified understanding to this kind of disease.Modern medicine mainly treated it by surgery while Traditional Chinese medicine believes it shoull be treated internally and externally.Complete resection of the lesion and the cosmetic effect is the focus of current research.This article reviews the progress of research in plasma cell mastitis etiology,pathology,diagnosis and treatment.
ABSTRACT
Objective To explore the diagnosis and treatment strategy of mammary duct ectasia.Methods The clinical data of 59 cases with mammary duct ectasia from January 2006 to December 2013 were analyzed retrospectively.Results The main clinical manifestations of mammary duct ectasia were mammary inflammatory mass in 46 cases,nipple discharge in 21 cases,nipple retraction in 18 cases,mammary abscess and mammary fistula in 8 cases.Definite diagnosis of mammary duct ectasia depended on pathology.All the patients were treated by operation,followed up for 3 months to 6 years,and none of them had recurrence.Conclusions Operation is the main method of curing mammary duct ectasia.To select proper operation time and method according to disease type,lesion size,location and scope.Thorough resection,repeat rinsing,wound clearance and immediate breast shape can not only cure disease,but also reserve breast configuration as possible.Therapeutic effect is satisfactory.
ABSTRACT
Objective To investigate the effect of surgical treatment of mammary duct fistula.Methods A total of 48 cases of mammary duct fistula were surgically treated,including 39 cases of fistulectomy and partial mastectomy,4 cases of total mastectomy,3 cases of subcutaneous mastectomy,and 2 cases of papillectomy.The incision was primarily sutured in 33 cases and kept open for drainage in 15 cases.Results A follow-up was carried out in the 48 cases for 3 months ~ 8 years(mean,3 years).Out of the 33 cases of primary closure of wound,5 cases developed a recurrence and then were cured by drainage and regular dressing change.The remaining 43 cases were cured on one session. Conclusions Fistulectomy is the basis of the treatment of mammary duct fistula.For a good cosmetic appearance and a short hospital stay,the operation should be performed with primary closure of wound,unless the recurrence is more likely to happen.
ABSTRACT
Objective To study X-ray differential diagnosis of the occupied lesions of the mammary ducts. Methods X-ray features, clinical manifestations and pathological result in 103 patients with pathologically-proved mammary ductal lesions were retrospectively analyzed.Results The mammary ductal occupied lesions in the study included intraductal papilloma (n=70), intraductal papillary carcinoma (n=15), intraductal papillomatosis (n=11), intraductal chronic mastitis (n=7).Conclusion The section, morphological features, size, number and the ductal variety of the lesions and discharge quality are of great value for the differential diagnosis of occupied lesions.
ABSTRACT
cases of plasma cell mastitis were treated from 1986 to 1999,of whom 37(32.5%) suffered from subareolar abcess and sclerosis,77(67 5%)had subareolar fistula.There were 58 cases(50 8%)of crater nipple.We adopted an arc incision along the edge of areolamammae to remove the necrotic tissues of the ducts,followed by everting suture and mamilliplasty.104 cases(91 2%)achieved healing by first intention.The operations were well done with little injury.Moreover,patients would be satisfied with the appearance.
ABSTRACT
Objective To discuss the diagnosis and treatment of ductoscopy for intraductal non-protruding lesions. Methods A retrospective analysis was made on characteristics, morphological features, and curative effects of 165 cases of intraductal non-protruding lesions between December 2002 and October 2005. Results Among the 165 cases, there were 135 cases of plasma cell galactophoritis, 18 cases of cystic mastopathy, and 12 cases of galactophoritis. In 144 cases receiving non-surgical treatment, 82 cases were completely relieved and 62 improved. Other 21 cases of plasma cell galactophoritis were surgically treated. Conclusions Mammary ductoscopy is an important way for the diagnosis of intraductal non-protruding lesions. Furthermore, effective treatment can be achieved under ductoscopy in most of cases, and unnecessary surgery may be avoided.
ABSTRACT
Objective To explore the X-ray characteristic findings of the intraductal papilloma to improve the radiologic diagnostic rate.Methods The mammographic data of 70 cases with intraductal papilloma of breast by pathology were analysed.Results Among 66 patients with nipple discharge 29 cases showed circular filling defect,7 cases showed stringy filling defect,17 cases had irregular filling defect,13 cases had mammary duct blocked ;4 cases with no nipple discharge all showed nodes.Conclusion To recognize the specific X-ray findings of intraductal papilloma of breast is valuable for diagnosis.
ABSTRACT
Objective To compare the effect of the different operation for mammary duct fistula (MDF). Method The clinical data of 85 cases of MDF were analysed retrospectively. Continuous section examinations between the multiple fistula was performed in 3 cases undergoing breastectomy.Results Among the 85 cases with 146 MDF, the opening located within 5cm around areola in 129 cases. MDF incision was performed on 38 cases, 34 cases cured, 4 cases recurred;MDF resection was performed in 44 cases, all the 44 cases were cured;simple mastectomy was performed on 3 cases of extensive breast inflammation,all the 3 cases cured. Conclusions Most of MDF occurs in main mammary duct. Most of the opening of MDF are around the areola. MDF incision or resection is the first choice of operation.
ABSTRACT
Objective:To improve the radiologic diagnostic and treatable rate of mannmmary ductal diseases.Methods:We retrospectively analyzed the galactographic materials of 369 cases.Results:The mammary ducts were classified into 4 types according to their morpholgy,including general fruticoses,multiple fruticoses,less fruticoses and single fruticoses.In this group,the multiple and less fruticoses were the most common,the general and single fruticoses were the less.Conclusion:Understanding radiologic anatomy of mammary duct is very valuable in the diagnosis and treatment of mammary ductal diseases. [
ABSTRACT
This paper analyses and discusses of the mammary duct ectasia. The review of 51 cases of mammary diagnostic name and pathogenesis duct ectasia shows that mammary duct ectasia and plasma cell mastitis are the two stages of one disease. It is generally caused by disturbance in the secretion of mammary glands. It is difficult to distinguish it from breast neoplasms. Therefor, we also analyse why the disease is more likely to be misdiognosed as breast cancer and also represent its differential diagnosis. The paper involves some measures of treatment.