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Intraductal papilloma

  • Definition
    • Intraductal papilloma is a small, noncancerous (benign) tumor that grows in a milk duct of the breast.

  • Causes
    • Intraductal papilloma occurs most often in women ages 35 to 55. The causes and risk factors are unknown.

  • Symptoms
    • Symptoms include:

      • Breast lump
      • Nipple discharge, which may be clear or bloodstained

      These findings may be in just 1 breast or in both breasts.

      For the most part, these papillomas do not cause pain.

  • Exams and Tests
    • The health care provider might feel a small lump under the nipple, but this lump cannot always be felt. There may be discharge from the nipple.

      A mammogram should be performed, but may not show a papilloma. Ultrasound may be helpful.

      Other tests include:

      • A breast biopsy to rule out cancer. If you have nipple discharge, a surgical biopsy is performed. If you have a lump, sometimes a needle biopsy can be done to make a diagnosis.
      • An examination of discharge released from the breast to see if the cells are abnormal (atypical) or indicate cancer.
      • An x-ray with contrast dye injected into the affected duct (ductogram). This test has been mostly replaced by ultrasound.
  • Treatment
    • The duct is removed with surgery. The cells are checked for cancer (biopsy).

  • Support Groups
    • There may be support groups for women with breast disease in your area. Ask your provider for a recommendation.

  • Outlook (Prognosis)
    • For the most part, intraductal papillomas do not appear to increase the risk for developing breast cancer.

      The outcome is excellent for people with 1 papilloma. The risk for cancer may be higher for:

      • Women with many papillomas
      • Women who get them at an early age
      • Women with a family history of cancer
      • Women who have abnormal cells in the biopsy
  • Possible Complications
    • Complications of surgery can include bleeding, infection, and anesthesia risks. If the biopsy shows cancer, you may need further surgery.

  • When to Contact a Medical Professional
    • Call your provider if you notice any breast discharge or a breast lump.

  • Prevention
    • There is no known way to prevent intraductal papilloma. Breast self-exams and screening mammograms can help detect the disease early.

  • References
    • Davidson NE. Breast cancer and benign breast disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 198.

      Hunt KK, Green MC, Buccholz TA. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 36.