Clinical and Imaging Characteristics in the Diagnosis and Surgical Management of Nipple Discharge Without Clinically Palpable Masses: A Retrospective Cohort Study.

IF 2.6 3区医学 Q3 ONCOLOGY

Thoracic Cancer Pub Date : 2026-06-01 DOI:10.1111/1759-7714.70332

Yang Yang, Ting Lin, Jiaxuan Li, Houpu Yang, Fei Xie, Siyuan Wang, Dingbao Chen, Shu Wang, Lei Chen, Miao Liu

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引用次数: 0

Abstract

Background: The study aimed to investigate clinical and imaging features in the diagnosis and surgical management of nipple discharge without palpable masses.

Methods: Consecutive patients undergoing surgery for nipple discharge without palpable masses (January 2014-December 2024) were retrospectively enrolled. Clinical, imaging (ultrasound, mammography, MRI), surgical, and pathological data were analyzed. Diagnostic performance of imaging modalities for intraductal lesions/malignancy and their role in incision selection were evaluated. Multivariate regression identified independent risk factors.

Results: Among 664 patients (676 breasts), 512 were pathology-positive cases. Older age (> 50 years), postmenopausal status, bloody/yellow discharge, and single-duct involvement correlated with intraductal-lesions/malignancy (p < 0.05). MRI demonstrated superior sensitivity for detecting intraductal-lesions (81.25%) and cancer (87.32%) versus ultrasound (64.51%/74.26%) and mammography (26.46%/50.39%), with 84.62% concordance in surgical localization. Bloody/yellow discharge, positive ultrasound, and MRI independently predicted intraductal-lesions (p < 0.05).

Conclusion: MRI offers optimal diagnostic sensitivity and precise spatial guidance for surgery. Bloody/yellow discharge, along with positive ultrasound and MRI findings, informs risk stratification and surgical intervention.

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无临床可触及肿块的乳头溢液的诊断和外科治疗的临床和影像学特征：一项回顾性队列研究。

背景：本研究旨在探讨无可触及肿块的乳头溢液的临床和影像学特征及手术处理。方法：回顾性分析2014年1月至2024年12月连续接受乳头溢液手术且未触及肿块的患者。对临床、影像学（超声、乳房x光、MRI）、手术和病理资料进行分析。评估了导管内病变/恶性肿瘤的影像学诊断表现及其在切口选择中的作用。多因素回归确定了独立的危险因素。结果：664例患者（676个乳房）中，病理阳性512例。年龄较大（50岁以下）、绝经后状态、带血/黄色分泌物、单管受损伤与导管内病变/恶性肿瘤相关(p结论：MRI提供了最佳的诊断敏感性和精确的手术空间指导。血/黄色分泌物，以及超声和MRI阳性结果，提示危险分层和手术干预。

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来源期刊

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.