An intraductal papilloma is a small tumor that can form in the milk ducts of the breast. This is a completely benign breast disease and does not normally increase the risk of cancer. In some women, multiple papillomas occurring at the same time may indicate a slightly increased risk of developing breast cancer, particularly if there is a family history of breast cancer.
Intraductal papillomas form when fibrous tissue begins to overgrow. They tend to remain small in size. One of the most obvious symptoms of intraductal papilloma is nipple discharge from a milk duct. Sometimes a small lump can be felt under the nipple, but this is not always the case, depending on the position of the lump. A breast may become slightly enlarged if the lump grows significantly and some pain may be felt in the breast.
The diagnosis of an intraductal papilloma sometimes requires some exclusion tests to rule out the possibility of cancer. These may include a breast biopsy or ductogram. During the biopsy, a needle is inserted into the lump to remove a small sample of fluid or tissue. A ductogram involves an injection of high-contrast dye into the duct, followed by an X-ray. Using the dye in this way allows the lump to show up on an X-ray.
Treatment for an intraductal papilloma is not always necessary. In some cases, the lump is very small and does not grow any further. As long as there are no complications, the lump can be safely left in place. If the lump grows, becomes uncomfortable or painful, or may interfere with milk production or breastfeeding, surgery may be needed to remove it.
Surgery to remove a papilloma is usually a simple procedure. During surgery, a small incision is made near the areola, through which the papilloma and associated milk duct are removed. Surgery does not usually cause serious side effects, but sometimes the wound site can bleed or become infected. In most cases, the surgery does not leave a detectable scar.
There is no preventive treatment for intraductal papilloma. Also, since there are no known causes or risk factors, it is almost impossible to assess the relative risk in women of different ages or lifestyles. A regular breast self-examination, along with regular mammography screening for older women, is the best way to ensure that a papilloma or other type of benign breast tumor can be quickly diagnosed and treated.