What is an Intraductal Papilloma?:
An intraductal papilloma is a tiny wart-like growth in breast tissue that sometimes punctures a duct. These benign tumors are composed of fibrous tissue and blood vessels. Intraductal papillomas grow inside your breast's milk ducts, and can cause benign nipple discharge.
What do Intraductal Papillomas Feel Like?:
If you have just one intraductal papilloma, and it is near or just beside a nipple, it may feel like a small lump. Solitary intraductal papillomas usually occur in the large milk ducts near your nipple. When one of these breaks a duct, it can cause a little clear or bloody nipple discharge, which is usually not worrisome. If you have multiple papillomas, they usually occur deeper inside your breast, and can't easily be felt. A group of papillomas like this won't cause nipple discharge.
Getting a Clear Diagnosis:
If you find a small lump quite near your nipple and see some discharge, keep an eye on it. If it doesn't grow, and the discharge ceases, chances are it is benign. See your doctor or nurse practitioner for a clinical breast exam, or if you want to have the fluid tested. If the lump is large enough for you to easily feel it, you may want to have a needle biopsy done, and the tissue sample examined. You may also consider having the lump imaged, a technique called a ductogram.
What is a Ductogram (Galactogram)?:
A ductogram, or galactogram, is an imaging study done specifically on the milk duct system. To begin this procedure, a patient must squeeze a small bit of discharge from the nipple, so that the radiologist can see exactly which duct is leaking. Once the duct is found, the radiologist gently inserts a very fine hollow needle into the duct, and injects some contrast fluid into the duct network. This contrast fluid will show up on a mammogram, and trace the related ducts. The resulting image may help to reveal the cause of your nipple discharge.
Types of Intraductal Papillomas:
There are two types, and one related condition:
- Solitary intraductal papillomas – one lump, usually near a nipple, causes nipple discharge
- Multiple papillomas – groups of lumps, farther away from a nipple, usually doesn't cause discharge, and can't be felt
- Papillomatosis – very small groups of cells inside the ducts, a type of hyperplasia, more scattered than multiple papillomas
How are Intraductal Papillomas Treated?:
Intraductal papillomas can be surgically removed if they prove bothersome. A small incision is made along the edge of your areola, then the papilloma and its duct are removed. The resulting scar can be nearly undetectable.
Do Intraductal Papillomas Increase Your Risk for Breast Cancer?:
Having solitary intraductal papillomas does not increase your risk for breast cancer, unless they are composed of other conditions, such as atypical hyperplasia. If you have multiple papillomas or papillomatosis, your risk for developing breast cancer is slightly increased.
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