Intraductal papilloma

A benign breast condition involving the milk ducts

Intraductal papilloma is a non-cancerous (benign) breast condition characterized by the growth of small, wart-like tumors in the milk ducts of the breast. These growths are typically found near the nipple and can cause nipple discharge or discomfort. While intraductal papillomas are benign, they can sometimes be associated with an increased risk of breast cancer.

Pathophysiology

Intraductal papillomas are composed of fibrous tissue and blood vessels, and they develop within the milk ducts of the breast. These growths can occur singly (solitary papillomas) or in multiples (multiple papillomas). Solitary papillomas are usually found in the larger ducts near the nipple, while multiple papillomas tend to occur deeper within the breast tissue.

Clinical Presentation

Patients with intraductal papilloma may present with:

• Nipple discharge, which can be clear, serous, or bloody.
• A palpable lump near the nipple.
• Breast pain or tenderness.

The discharge is often spontaneous and may be the only symptom. In some cases, the papilloma may be detected during a routine mammography or breast ultrasound.

Diagnosis

The diagnosis of intraductal papilloma typically involves:

• Physical examination: A healthcare provider may feel a small lump near the nipple.
• Imaging studies: Mammography and ultrasound can help visualize the papilloma.
• Ductography: A specialized imaging technique where contrast dye is injected into the milk ducts to highlight abnormalities.
• Biopsy: A core needle biopsy or excisional biopsy may be performed to obtain a tissue sample for histological examination.

Treatment

The primary treatment for intraductal papilloma is surgical excision. This involves removing the papilloma and a small margin of surrounding tissue to ensure complete removal. Surgery is often recommended to alleviate symptoms and to rule out any associated malignancy.

Prognosis

The prognosis for individuals with intraductal papilloma is generally excellent, as these lesions are benign. However, regular follow-up is important, especially if there are multiple papillomas or if there is any atypical hyperplasia, as these conditions may increase the risk of developing breast cancer.

Prevention and Risk Factors

While there are no specific measures to prevent intraductal papilloma, awareness of breast changes and regular breast examinations can aid in early detection. Risk factors may include:

• Age: Most common in women aged 35-55.
• Hormonal factors: Estrogen exposure may play a role.

Related pages

• Breast cancer
• Mammography
• Breast ultrasound
• Biopsy

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