Breast

Intraductal Papilloma

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Intraductal Papilloma

  • Definition
  1. Wart-like benign Breast tissue growth within the Lactation ducts
  • Epidemiology
  1. Peak Incidence: age 35-55 years old (mean age 48 years old)
  • Pathophysiology
  1. Mechanism of growth appears to be proliferative fibrocystic epithelial hyperplasia
  2. Broad-based or pedunculated polypoid epithelial growth of size 2-3 mm and within Lactation duct
  3. Localized within 1 cm of nipple in 90% of cases
  • Symptoms
  1. Nipple Discharge (clear or bloody)
  • Imaging
  1. Mammogram
    1. Typically normal
  2. Breast Ultrasound
    1. May demonstrate Intraductal Papilloma
  • Diagnosis
  1. Breast biopsy
    1. Distinguishes Intraductal Papilloma from Breast Cancer as a cause of bloody Breast Discharge
  • Complications
  1. Breast cysts
    1. Related to Lactation duct obstruction by papilloma
  • Prognosis
  1. Solitary Intraductal Papilloma
    1. Benign growths, but do confer a 1.5 to 2 fold increased lifetime risk of Breast Cancer
  2. Multiple Intraductal Papillomas
    1. Considered premalignant condition (similar risk to lobular carcinoma in situ or LCIS) with lifetime relative Breast Cancer risk of 7.4
    2. Multiple papillomas have a predisposition for terminal lobular ducts where ductal carcinoma frequently arises
  • References
  1. Pisano (1999) Radiology 210: 795-798 [PubMed]