乳腺结核诊断与治疗专家共识

doi:10.19982/j.issn.1000-6621.20260010

摘要/Abstract

摘要：

乳腺结核是由结核分枝杆菌感染所致的肺外结核类型,尽管发病率低,因临床表现及影像学特征均缺乏特异性,易与乳腺癌、肉芽肿性乳腺炎等疾病混淆,误诊率高,局部破坏性强。近年来随着免疫抑制人群增多,其发病率呈上升趋势。目前,国内外尚缺乏针对乳腺结核的专项诊疗指南,临床实践多参照肺外结核诊疗原则,存在一定局限性。为规范乳腺结核的临床管理,由江西省胸科医院/江西省卫生健康结核病重点实验室、中国防痨协会、广州国家实验室联合临床多学科专家,基于GRADE系统及德尔菲法制定本共识。本共识系统阐述乳腺结核的流行病学特征、临床表现、影像与病理学特点,明确其分层诊断标准,强调病原学及分子生物学检查在确诊中的核心价值,并提出以规范化抗结核治疗为基础、个体化外科干预为辅助的综合治疗策略。本共识旨在为临床医师提供循证依据,提升乳腺结核的早期识别与精准诊疗水平,改善患者预后。

关键词: 结核,乳腺, 诊断, 治疗学, 总结性报告(主题)

Abstract:

Breast tuberculosis is a form of extrapulmonary tuberculosis caused by Mycobacterium tuberculosis infection. Although its overall incidence is low, it is characterized by nonspecific clinical manifestations and imaging features, making it prone to confusion with diseases such as breast cancer and granulomatous mastitis. This often leads to a high rate of misdiagnosis and significant local tissue destruction. In recent years, the incidence of breast tuberculosis has shown an upward trend due to the increasing population of immunocompromised individuals. Currently, there is a lack of specific guidelines for the diagnosis and treatment of breast tuberculosis both domestically and internationally; clinical practice largely relies on general principles for extrapulmonary tuberculosis, which presents certain limitations. To standardize the clinical management of breast tuberculosis, the Jiangxi Chest Hospital/Jiangxi Provincial Health and Health Commission Key Laboratory of Tuberculosis, the Chinese Antituberculosis Association, and Guangzhou National Laboratory, in collaboration with multidisciplinary clinical experts, have formulated this consensus based on the GRADE system and the Delphi method. This consensus systematically elucidates the epidemiological characteristics, clinical manifestations, and imaging and pathological features of breast tuberculosis. It clarifies stratified diagnostic criteria, underscores the pivotal role of etiological and molecular biological examinations in definitive diagnosis, and proposes a comprehensive treatment strategy anchored in standardized anti-tuberculosis therapy and supplemented by individualized surgical intervention. This consensus aims to provide clinicians with evidence-based guidance to enhance the early recognition, precise diagnosis, and treatment of breast tuberculosis, thereby improving patient prognosis.

Key words: Breast tuberculosis, Diagnosis, Therapeutics, Consensus development conferences as topic

中图分类号:

R655.8

江西省胸科医院/江西省卫生健康结核病重点实验室, 中国防痨协会, 广州国家实验室. 乳腺结核诊断与治疗专家共识[J]. 中国防痨杂志, 2026, 48(6): 737-750. doi: 10.19982/j.issn.1000-6621.20260010

Jiangxi Chest Hospital/Jiangxi Provincial Key Laboratory of Tuberculosis, Chinese Antituberculosis Association, Guangzhou National Laboratory. Expert consensus on the diagnosis and treatment of breast tuberculosis[J]. Chinese Journal of Antituberculosis, 2026, 48(6): 737-750. doi: 10.19982/j.issn.1000-6621.20260010

图/表 1

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