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Two hundred thirty-seven patients with nipple discharge during nine years between 1992 and 2000 were reviewed with regard to blood tests, secretion cytology, CEA in the nipple discharge and galactography. The sensitivity, specificity and positive predictive values of blood tests for breast cancer were 100%, 71.8% and 25.6%, respectively. The sensitivity, specificity and false negativity rates of secretion cytology (cut-off point was class IV) were 10%, 100% and 90%, respectively. When the cut off point was class III, these were 50%, 91.3% and 50%, respectively. The sensitivity, specificity and postive predictive values of CEA in the nipple discharge when the cut-off value was 1, 000 ng/ml were 53.3%, 96.2% and 72.7%, respectively, and 73.3%, 83.5% and 43.5% when the cut-off point was 400 ng/ml. The sensitivity and specificity of galactography were 81.8% and 36.1%, respectively. It was concluded that blood testing is the most important first screening examination for distinguishing the presence of breast cancer. As secretion cytology has poor sensitivity and high false positivity, we consider it to be insufficient as a screening examination. When there was a high risk of breast cancer, the CEA level in the nipple discharge was high. We consult with the patient when galactography, MRI and microdochectomy are considered necessary. Galactography has high sensitivity and gives valuable information for microdochectomy.
- 日本乳癌検診学会の論文
日本乳癌検診学会 | 論文
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