探讨临床对于乳腺增生(MGH)患者经彩色多普勒超声筛查发现的直径<1 cm乳腺结节的变化趋势。

选择2010年3～12月于石家庄市第四医院经彩色多普勒超声乳腺疾病筛查发现乳腺结节直径<1 cm的1 309例MGH患者为研究对象。采用回顾性分析方法分析其5年(2011－2015年)定期随访结果，包括乳腺结节直径、影像学评分、临床触诊评分、疼痛评分，以及手术率、乳腺非典型增生与癌变率，并进行统计学分析。

①对乳腺结节直径<1 cm的1 309例MGH患者从确诊至定期随访1、2、3、4、5年时，乳腺结节影像学评分保持稳定者分别为1 289、1 174、1 102、928、741例，评分增高者分别为20、119、164、301、413例，接受手术治疗者分别为4、12、27、37、75例，术后诊断为乳腺腺病者分别为4、10、17、24、45例，乳腺非典型增生者分别为0、2、8、11、26例，乳腺癌变者分别为0、0、2、2、4例。②本研究1 309例MGH患者从确诊至定期随访1、2、3、4、5年时，乳腺结节直径、影像学评分分别比较，差异均有统计学意义(F＝2 704.87，P<0.001；F＝200.03，P<0.001)，随着随访时间的延长，乳腺结节直径及影像学评分均升高；但是其乳腺结节的疼痛评分及临床触诊评分分别比较，差异均无统计学意义(F＝2.32，P＝0.054；F＝1.98，P＝0.094)。③本研究1 309例MGH患者的手术率及乳腺非典型增生率分别比较，差异均有统计学意义(χ²＝1 097.71，P<0.001；χ²＝48.45，P<0.001)。Cochran-Armitage趋势检验结果显示，随着随访时间的延长，乳腺结节患者手术率及乳腺非典型增生率均逐渐增加(Z＝9.913，P<0.001；Z＝6.488，P<0.001)。5年随访期内，本研究1 309例MGH患者乳腺结节癌变率比较，差异无统计学意义(χ²＝7.41，P＝0.091)。

随着时间延长，MGH患者的直径<1 cm乳腺结节有恶性病变风险，有必要采取个体化的临床干预措施。

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.

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.

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).

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.