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乳腺囊肿的临床表现、诊断和治疗

Authors
Christine Laronga, MD, FACS
Sharon Tollin, PhD, ARNP, AOCNP
Blaise Mooney, MD
Section Editor
Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
Deputy Editor
Wenliang Chen, MD, PhD
Translators
王钢乐, 主任医师

引言

乳腺囊肿是出现在终末导管小叶单位(terminal duct lobular unit, TDLU)的液体充盈而成的圆形或卵圆形肿块(影像 1)。由于输出导管阻塞并扩张，TDLU内发生液体聚积，从而形成囊肿[1]。 (参见“乳房的发育和形态”，关于‘小叶形成’一节)

乳腺囊肿可单发也可多发，出现乳腺囊肿的女性常会因为存在可触及的肿块或相关疼痛或不适而就医。乳腺囊肿可能最初在乳腺临床检查或自查时发现，也可在乳腺X线钼靶摄影检查中发现(呈致密影)。乳腺囊肿可能大小不一、数量不等，症状也可能不同。

流行病学

乳腺囊肿受激素功能和激素波动的影响。因此，在绝经前和围绝经期女性中，小叶发育期、月经周期改变时或小叶退化期，均可发生乳腺囊肿[2]。

乳腺囊肿在绝经前、围绝经期及绝经后的女性中很常见。美国放射影像网络学会(American College of Radiology Imaging Network, ACRIN)6666课题对2809例乳腺癌发生风险增加的女性进行了前瞻性研究，结果发现在所有筛查女性中37.5%检出乳腺囊肿，发病高峰年龄为35-50岁[3]。在为期3年的筛查研究中，与绝经后女性相比，绝经前女性检出乳腺囊肿的情况更多见(65.1% vs 39.4%)。有5.4%(73例)的绝经后女性使用过激素替代疗法(hormone replacement therapy, HRT)，66%的HRT使用者被诊断为乳腺囊肿。

有症状和无症状的小囊肿(微囊肿)常见于绝经前的年轻女性[4]。 (参见“良性乳腺疾病概述”，关于‘非增生性乳腺病变’一节和“Clinical manifestations and diagnosis of a palpable breast mass”, section on ‘Benign’)

                      

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Literature review current through: 2017-06 . | This topic last updated: 2016-09-06.
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