Intraductal Papilloma
Intraductal papilloma is a benign lesion that is found usually within the large milk ducks behind the nipple but maybe found elsewhere within the breast. It may present as :
- A lump close to the nipple
- Nipple discharge either bloody or watery yellow in nature from a single duct.
- As calcification on mammogram
- As a small lesion with in a duct on ultrasound
Intraductal papillomas will be seen on needle biopsy showing papillary cells. In up to about 5% of cases the papillary cell changes seen on needle biopsy may be associated with malignancy, either in situ or invasive cancer. It is very difficult to distinguish benign papilloma’s from these more uncommon malignancies and so excision of the papilloma is the usual management in most circumstances. This can either be done as an open surgical biopsy under general anaesthetic or in selected cases as a percutaneous vacuum excision biopsy under local anaesthetic.
Intraductal papillomas do not significantly increase a woman’s risk of breast cancer however if there is cellular change (atypia) in the papilloma or if a woman develops multiple papillomas, then their breast cancer risk is mildly increased. At BreastCare we would generally recommend screening mammography and ultrasound annually for these women.
