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目的:探讨伴有血性乳头溢液的乳腺癌保留乳头乳晕的可行性。方法:选取2016年1月至2018年12月首都医科大学附属北京同仁医院乳腺中心收治的术中选择并完成保留乳头乳晕的16例女性乳腺癌患者。年龄(49.6±6.2)岁，年龄范围为41～70岁。肿瘤最大径(2.5±1.4)cm，最大径范围为1.0～6.0 cm。对于有非肿块样强化(NME)的患者采用切除乳头内全部乳管，仅保留乳头乳晕皮肤或楔形切除部分乳头皮肤以及乳头内乳管的手术；对于无NME的患者采用完全保留乳头乳晕复合体(NAC)的手术方式。结果:13例患者行保留NAC的乳房切除术，3例患者行保乳手术。导管原位癌5例，黏液癌1例，浸润性导管癌2例，浸润性导管癌伴导管原位癌8例。术后乳头表皮坏死2例。随访24～48个月，无局部复发和远处转移病例。结论:对于伴有血性溢液但肿瘤未侵及NAC的乳腺癌，乳腺磁共振可作为保留NAC必要的影像学检查，同时对于NME延伸至乳头及乳头内乳管线样强化的病例，采用乳头内乳管切除而保留NAC具有较好的肿瘤安全性。“,”Objective:To investigate the feasibility of retaining nipple and areola in breast cancer with bloody nipple discharge.Methods:A total of 16 patients with breast cancer who underwent surgery and retaining nipple and areola were selected from January 2016 to December 2018.All patients were female, aged(49.6±6.2)years, the range of age was 41 to 70 years.The maximum diameter of the tumor was(2.5±1.4)cm, and the maximum diameter ranged from 1.0 cm to 6.0 cm.For patients with non-mass enhancement(NME), the entire nipple duct was removed, leaving only the nipple and areola skin, or part of the nipple was removed by wedge resection.For patients without NME, nipple-areolar complex(NAC)was preserved completely.Results:NAC was retained in 13 patients, 3 patients underwent breast-conserving surgery.5 patients were ductal carcinoma in situ, 1 patients was mucinous carcinoma, 2 patients were invasive ductal carcinoma, 8 patients were invasive ductal carcinoma with ductal carcinoma in situ.There were 2 patients with papillary epidermal necrosis.All patients were followed up 24 to 48 months.There was no local recurrence or distant metastasis.Conclusion:Magnetic resonance imaging is a necessary radiographic examination for the breast cancer with hemorrhagic discharge but not invasiving the NAC.For the NME extending to the nipple and intra-nipple duct enhancement, the use of internal nipple duct excision while preserving NAC has better tumor safety.