Papilloma

Intraductal Papilloma of the Breast: What You Need to Know

The intraductal papilloma is a benign growth that develops within the milk-producing ducts of the breast. It looks like a small "grape" and is often found near the nipple. It occurs most commonly in women aged 35 to 55 years, with a size that usually ranges from 1 to 2 centimeters. In 10% of cases, the papillomas are multiple and are located further away from the nipple.

Symptoms of Intraductal Papilloma

Common symptoms include:

• Nipple discharge, often bloody

• Palpable breast lump

If you experience any of these signs, it is important to consult a specialist promptly for evaluation.

Is papilloma associated with breast cancer?

Intraductal papillomas are generally benign and rarely progress to malignancy. However, when they contain atypical cells or coexist with other suspicious lesions, the risk of future malignancy increases. In such cases, surgical removal is recommended. Conversely, for small, solitary papillomas without atypia, careful monitoring may be an option in selected cases.

Diagnosis of Papilloma

Diagnosis can be made through:

• Imaging studies (usually breast ultrasound)

• Digital mammography or breast MRI

• Biopsy (fine needle, core needle, or surgical biopsy)

• Clinical examination when a palpable mass or nipple discharge is present

Definitive diagnosis is established by histological tissue analysis.

How is intraductal papilloma treated?

Classical treatment includes Surgical removal of the papilla along with the part of the milk duct in which it is located. The operation is performed through a small incision in the periphery of the nipple and the patient usually returns home the same day.

An alternative solution isremoval by suction through a vacuum needle under local anesthesia, in specialized breast centers.

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Bibliography:

1. Abbassi-Rahbar S, et al. Ann Surg Oncol. 2021;28(10):5768-5774. Multidisciplinary Review of Intraductal Papilloma of the Breast Can Identify Patients Who May Omit Surgical Excision.

1. Jee Y, et al. Am Surg. 2022;88(7):1467-1470.Intraductal Papilloma on Breast Biopsy: Upstaging Rate and Implications for Practice Guidelines

1. Lou C, et al. J Environ Pathol Toxicol Oncol. 2024;43(3):39-49. Treatment Strategy for Breast Benign Intraductal Papilloma: A Meta-Analysis

1. Swapp RE, et al. Ann Surg Oncol. 2013;20(6):1900-1905. Management of Benign Intraductal Solitary Papilloma Diagnosed on Core Needle Biopsy

1. Han LK, et al. Clin Breast Cancer. 2023;23(6):649-657.Intraductal Papilloma Without Atypia on Image-Guided Breast Biopsy

1. He H, et al. Ann Surg Oncol. 2016;23(5):1441-1447.Intraductal Papilloma with Benign Pathology on Breast Core Biopsy: Is Surgical Excision Necessary