Intraductal papilloma

Definition
Intraductal papilloma is a small, benign (non-cancerous) tumor that grows within a milk duct of the breast.

Causes, incidence, and risk factors

Intraductal papilloma occurs most frequently in women between the ages 35-55. The causes and risk factors are unknown.

Symptoms

     
  • breast pain  
  • nipple discharge, sometimes bloody, from one breast only  
  • staining may be noticed inside the bra and/or clothing  
  • breast lump  
  • breast enlargement

Signs and tests

     
  • Intraductal papilloma is the most common cause of spontaneous nipple discharge from a single duct.  
  • A small lump beneath the nipple may be felt by the examiner, but it is not always palpable.  
  • A mammogram often does not show papillomas. Ultrasound may be helpful.  
  • An x-ray with contrast injected into the affected duct (ductogram) may be performed.  
  • Cellular (cytologic) examination of discharge may be performed to identify potentially malignant (cancerous) cells.  
  • A breast biopsy is necessary to make a definitive diagnosis and rule out cancer.

Treatment

Surgical removal (excision) of the involved duct and the mass of cells is done for a biopsy and to assure that cancer is not present.

Support Groups
There may be local support groups available for women with breast disease in your area. You should ask your doctor or health care provider for recommendations.

Expectations (prognosis)

The outcome is expected to be excellent for patients with solitary tumors. Patients with multiple papillomas or who develop them at an early age may have an increased risk of developing cancer, particularly if they have a family history of cancer or there are abnormal cells in the biopsy.

Complications

The possible complications of surgery include bleeding, infection, and the risk of the anaesthesia used. If the biopsy shows cancer, further surgery may be needed.

Calling your health care provider

Call for your health care provider if you notice any breast discharge or discover a breast lump.

Prevention

There is no known prevention. Breast self-examination and screening mammography may allow early detection.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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