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intraductal papilloma

What are Papillomas and Why do They Need to be Excised?

If you feel a lump in your breast or have nipple discharge, don’t automatically assume you have breast cancer. There are benign breast conditions that can also cause lumps and bloody nipple discharge, such as an intraductal papillomas. This is a small non-cancerous tumor that forms in the milk duct of the breast. There are no known risk factors to indicate which women might be more likely to develop an intraductal papilloma.

Milk ducts in the breast are larger near the nipple and become smaller the farther they are from the nipple. When a single papilloma grows in a larger milk duct, it’s called an intraductal papilloma. This typically feels like a small lump behind or near the nipple that may cause nipple discharge or bleeding, and sometimes pain. Sometimes a lump cannot be felt and only discharge or bleeding will occur.

An ultrasound and/or mammography can and should be done to determine the size and location of the papilloma. If the papilloma is large enough to be felt or seen on ultrasound, a biopsy can be done, so that tissue from the growth can be examined under the microscope.

Surgery is the recommended treatment to remove the papilloma and the part of the duct it is in, so that the growth can be evaluated for any indications of cancer. Most intraductal papillomas are non-cancerous, however 17-20% have been shown to be cancerous upon complete removal of the growth. In addition, about 20% of intraductal papillomas contain abnormal cells. Because there is even a small risk of cancer, papillomas should be surgically removed and biopsied.

The difference between a benign and cancerous papilloma cannot always be appreciated after a needle biopsy. Usually the whole papilloma needs to be evaluated by a pathologist, under the microscope before a benign papilloma can be confirmed.

If you have been found to have a papilloma after a needle biopsy, you should consult with a physician who specializes with benign diseases of the breast.
While there is no specific way to prevent an intraductal papillomas, you can increase the likelihood of early detection by seeing your doctor regularly for breast exams, performing breast self examinations every month and doing annual mammography screenings. You should also call your doctor if you have any concerns about anything related to breast health, such as these small lumps or nipple discharge.

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