Intraductal papilloma: What you need to know
An intraductal papilloma is not breast cancer, and it does not mean that a person will have breast cancer.
However, having several papillomas can increase the risk of developing cancer in the future. For this reason, it is a good idea to seek medical attention.
In this article, learn more about intraductal papillomas, how to recognize them, and what to do if they form.
A mammogram or ultrasound can diagnose an intraductal papilloma.
A solitary intraductal papilloma is a single tumor that forms near the nipple, in the largest milk duct.
Symptoms of a solitary intraductal papilloma include:
- clear or bloody nipple discharge
- a lump behind or next to the nipple
This condition mostly affects females and rarely occurs in males. If an intraductal papilloma develops while breastfeeding, there may be a small amount of blood in the breast milk.
Multiple intraductal papillomas are smaller and form in smaller milk ducts, farther away from the nipple.
These lumps develop deeper within the breast, so they may be harder to feel. Multiple intraductal papillomas are also less likely to cause nipple discharge.
Symptoms of intraductal papilloma, whether solitary or multiple, can resemble those of breast cancer and other conditions. For this reason, it is important to see a doctor about any changes in the breast, including lumps, nipple discharge, pain, or itching.
A person may learn that they have an intraductal papilloma after bringing breast-related symptoms to a doctor's attention. Routine screening can also reveal this condition.
A doctor may diagnose an intraductal papilloma after:
A physical examination: The doctor will check for nipple discharge and changes in the shape and texture of the breasts.
Laboratory tests: Nipple discharge can contain cells that indicate cancer.
Mammary ductoscopy: This procedure involves using a very thin, tubular tool to collect samples and images from within the ducts.
A ductoscopy allows a doctor to take gather information about the size and location of the changes in the breast.
The information can help them determine whether to take a biopsy and whether to rule out other conditions, such as atypical ductal hyperplasia and ductal carcinoma in situ. These conditions involve abnormal cells in the milk ducts, and both can increase the risk of developing invasive breast cancer.
A doctor will advise on the best treatment option.
A doctor usually recommends surgery to remove an intraductal papilloma.
The surgeon will remove the growth and the affected portion of the milk duct but leave the unaffected areas of the breast intact. The procedure will take place under general anesthesia.
Removing part of the milk duct can cause complications with breastfeeding. Anyone who is planning to breastfeed should discuss it with the surgeon. People who are currently breastfeeding should also speak with a lactation consultant.
Intraductal papillomas are not breast cancer, and having one does not mean that a person will develop breast cancer.
However, having multiple papillomas increases the risk of breast cancer, according to the National Cancer Institute.
A 2017 study looked at biopsy results from 520 growths that doctors had diagnosed as papillomas after checking ultrasounds. The researchers noted that 44 of these growths — or 17.6% — were ultimately atypical or cancerous.
A study from the previous year compared results of biopsies with results of testing after surgical removal. Of 119 growths that biopsies had indicated to be papillomas, 21% were found to contain atypical cells. Having atypical cells does not mean that cancer is present, but it can increase the risk of malignancy.
Because biopsies are not entirely accurate, doctors recommend that people consider surgery to remove intraductal papillomas.
Anyone with multiple intraductal papillomas should discuss risk factors for breast cancer with their doctor, even if tests show that the cells are benign. They may need to establish a screening schedule.
If the cells within the intraductal papilloma are noncancerous, the outlook is usually good after surgery to remove the growth.
If atypical or cancerous cells are present, a doctor may recommend more frequent screenings or treatment, such as medication or additional surgery.
There is currently no way to prevent papillomas from developing, but some measures can ensure early diagnosis and prompt treatment if changes occur.
The American College of Physicians recommend that all women speak to their doctors about screening from around the age of 40. For those with an average risk, they recommend having a mammogram every 2 years from ages 50–74.
Some organizations, such as the American Cancer Society, have other recommendations.
Each person is different, and some people have a higher risk than others. It is important to determine the right screening schedule with a doctor.
People with a high risk of breast cancer usually have:
- a personal history of breast cancer or a high-risk breast lesion
- genetic factors, such as a mutation of the BRCA1 or BRCA2 gene
- childhood radiation exposure to the chest
Consult a doctor about any breast-related changes as soon as possible. Early treatment for breast cancer is highly effective.
Intraductal papillomas are harmless growths that develop in the ducts that run through the breast. Though they are noncancerous, having multiple papillomas can increase the risk of cancer.
Anyone who notices breast-related changes should consult a doctor. If tests reveal papillomas, the doctor can help determine the best strategy for treatment or monitoring.