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Intraductal Papillomas

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Solitary intraductal papillomas are tumors of the major lactiferous ducts. They occur most frequently in women 30 to 40 years of age, and frequently present with nipple discharge.

Solitary intraductal papillomas are tumors of the major lactiferous ducts. They occur most frequently in women 30 to 40 years of age, and frequently present with nipple discharge-which may be serous or bloody. Bloody discharge occurs in approximately 50% of cases.

Intraductal papillomas are generally less than 1 cm in diameter (they usually measure 3 to 4 mm). Occasionally, these lesions may be as large as 4 to 5 cm. Current evidence suggests that these lesions rarely undergo malignant transformation.

Compared with solitary lesions, multiple intraductal papillomas tend to occur in younger patients, are associated with nipple discharge less often, and are more frequently peripheral and bilateral. Most important, women with multiple lesions appear to be more susceptible to breast cancer than are women with solitary tumors. In either case, excision is the usual treatment. Some clinicians recommend observation for nonbleeding solitary papillomas.

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