Retrospective analysis of regular follow-up results of mammary gland hyperplasia patients with small diameter mammary nodules

Abstract

Objective To explore the necessity of clinical intervention for diameter <1 cm mammary nodules screened by breast color Doppler ultrasound in mammary gland hyperplasia (MGH) patients. Methods From March to December 2010, a total of 1 309 cases of patients with diameter <1 cm mammary nodules screened by breast color Doppler ultrasound in the Fourth Hospital of Shijiazhuang were selected as research subjects. The regular follow-up results of MGH patients by 5 years (2011 to 2015), such as the diameter, imaging score, clinical palpation score and pain score of mammary nodules, and rates of surgical treatment, incidence of atypical hyperplasia and breast cancer of MGH patients were analyzed by retrospective analysis method and statistical methods. Results ①The regular follow-up results of 1 309 cases of MGH patients by 1-, 2-, 3-, 4- and 5-year showed that, 1 289, 1 174, 1 102, 928 and 741 cases of patients′ mammary nodules imaging scores remained stable respectively, and 20, 119, 164, 301 and 413 cases of patients′ mammary nodules imaging scores increased respectively, of which 4, 10, 17, 24 and 45 cases underwent surgical treatment respectively, and 4, 10, 17, 24 and 45 cases were diagnosed as breast adenosis by postoperative pathology diagnosis respectively, and 0, 2, 8, 11 and 26 cases were diagnosed as atypical hyperplasia respectively, and 0, 0, 2, 2 and 4 cases were diagnosed as breast cancer respectively. ②There were statistical differences in the diameters and imaging scores of mammary nodules among 1 309 cases of MGH patients from 2011 to 2015 (F=2 704.87, P<0.001; F=200.03, P<0.001). With the extension of follow-up time, the diameters and imaging scores of mammary nodules increased. But there were no statistical differences in the pain scores and clinical palpation scores of mammary nodules among 1 309 cases of MGH patients from 2011 to 2015 (F=2.32, P=0.054; F=1.98, P=0.094). ③There were statistical differences in the surgical rate and the incidence of atypical hyperplasia among 1 309 cases of MGH patients with mammary nodules from 2011 to 2015 (χ2=1 097.71, P<0.001; χ2=48.45, P<0.001). Cochran-Armitage trend test results showed that with the extension of follow-up time, both the surgical rate and the incidence of atypical hyperplasia increased gradually (Z=9.913, P<0.001; Z=6.488, P<0.001). There was no statistical difference in the incidence of breast cancer among 1 309 cases of MGH patients mammary nodules from 2011 to 2015 (χ2=7.41, P=0.091). Conclusions With time prolonged, the mammary nodule with diameter <1 cm of MGH patient has the risk of developing into malignant lesions, so it is necessary to carry out individualized clinical intervention measures for it. Key words: Mammary gland hyperplasia; Mammary nodule; Malignant lesions risk; Follow-up studies; Clinical intervention