The Clinical Research Of Intraductal Lesion In Non-pathological Nipple Discharge Patients

Background Intraductal lesions are closely related to the development of breast cancer and mainly manifested as pathological nipple discharge(PND).In recent years,some patients with intraductal lesions were found without PND,which may result in the missed diagnosis or misdiagnosis.Objective The purpose of this study was to investigate the risk factors,clinical and imaging features of intraductal lesions in non-PND patients.Methods A retrospective case-control study was performed to analyze the medical records data of 278 non-PND patients who underwent surgical treatment at the Department of Breast Surgery within China-Japan Union Hospital of Jilin University(2016-04-01 to 2017-04-30).According to pathological results,the patients were divided into intraductal lesions group and non-intraductal lesions group.The clinical data were collected for univariate and logistic regression analysis,to analyze the clinical features and the risk factors of intraductal lesions in non-PND patients.Imaging data were collected to analyze the imaging features of the intraductal lesions.Results A total of 278 non-PND patients with 370 diseased breasts(92 patients with bilateral lesions of the same type),127(46%)with intraductal lesions,and 151(54%)with non-intraductal lesions;postoperative pathological diagnosis of intraductal lesions in 156 cases,diagnosed as non-intraductal lesions in 214 cases.Univariate analysis showed that age(χ2=29.785,p<0.001),number of pregnancies(χ2=10.916,p=0.001),number of abortions(χ2=6.359,p=0.012),and non-menstrual breast pain(χ2=51.486,p<0.001)were significantly different between the two groups.Multivariate logistic regression analyses showed that age in 35-50 years old and age>50 years old(OR=5.099/7.250)were the risk factors of intraductal lesions in non-PND patients.Analysis of all diseased breast imaging features revealed that there was a statistically significant difference in the duct ectasia(χ2=21.947,p<0.001),the lesion size(χ2=16.824,p<0.001)and the lesion distance from the nipple(χ2=15.171,p<0.001)between intraductal lesions and non-intraductal lesions.Conclusion For patients who aged over 35,companying symptoms like non-menstrual breast pain,and ultrasound showed duct ectasia,the lesion distance from nipple ≤2cm and the lesion size ≤1cm,although there is no PND occurred,clinicians should still be highly concerned about the possibility of intraductal lesions,to reduce missed diagnosis,misdiagnosis rate.