Intraductal papilloma

Question 1

What is intraductal papilloma of the breast?

Answer 1

Local areas of epithelial proliferation in large mammary ducts

Question 2

What are the 2 types of intraductal papillomas?

Answer 2

Solitary (aka. central papillomas): benign
Multiple (aka. peripheral papillomas): a/w atypia, DCIS, invasive breast cancer

Question 3

How do solitary papillomas present?

Answer 3

Bloody/ serous discharge (usually from single duct)
Palpable retroareolar mass (if large)

Question 4

How do multiple papillomas present?

Answer 4

May be asymptomatic
+/- peripheral palpable breast mass
Nipple discharge is uncommon.

Question 5

Describe investigations for papillomas

Answer 5

Triple assessment
US: well-defined solid nodule or mass within a dilated lactiferous duct
Mammogram: normal or well-defined mass with calcifications
Core needle biopsy: to identify cellular atypia

Question 6

Describe management of papillomas

Answer 6

Microdochectomy (excision of duct)