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Breast tumors aren’t always indicative of cancer. Benign breast conditions can also cause lumps. One of these conditions is intraductal papilloma.
An intraductal papilloma is a small, benign tumor that forms in a milk duct in the breast. These tumors are made of gland and fibrous tissue as well as blood vessels. They most commonly occur in women between ages 35 and 55. There are no known risk factors for intraductal papilloma.
When a single tumor grows in large milk ducts, it’s called a solitary intraductal papilloma. It’s typically felt as a small lump near the nipple, and it may cause nipple discharge or bleeding. This type of lump isn’t associated with a higher risk of breast cancer.
Ducts farther away from your nipple are smaller, and papillomas in this area typically manifest as clusters of little tumors. These tumors are called multiple papillomas, and they’ve been associated with a slightly higher risk of breast cancer. This is because multiple papillomas have been linked to a precancerous breast condition called atypical hyperplasia.
A condition called papillomatosis is sometimes grouped in with intraductal papillomas. It develops when there’s an abnormal overgrowth of cells in your milk ducts. Papillomatosis is also associated with a higher risk of breast cancer.
An intraductal papilloma can cause breast enlargement, lumps, and nipple discharge. Some people might also experience pain or discomfort in their breast.
An intraductal papilloma typically presents as one larger lump near your nipple or as multiple smaller lumps farther from your nipple. These lumps are normally 1 to 2 centimeters wide, but they can also be larger. The size of the lump depends on the size of the duct where it grows. Sometimes you won’t even be able to feel the lump.
The symptoms of intraductal papilloma are very similar to those of other types of breast tumors. It’s important to see your doctor if you see or feel a lump in your breast. Your doctor can address any concerns you may have and examine the lump to help make a diagnosis.
What if blood is coming from the breast of a breastfeeding mother? In early breastfeeding, when accompanied by sore and damaged nipples, this is probably due to a poor latch. Getting help with breastfeeding from a lactation consultant can solve this problem.
If this bleeding is because of an intraductal papilloma, the bloody discharge will come from only one duct on one breast, and it’ll be painless.
You should continue to breastfeed on the other breast. Pump the breast that is bleeding and discard the milk with visible blood in it. Use a low setting on the breast pump.
The bleeding will usually stop on its own without any treatment. If the bleeding persists past a couple of days, see your doctor. You may require treatment, but this can be done with care not to interfere with breastfeeding.
Your doctor may recommend a breast ultrasound if they suspect you have an intraductal papilloma. This type of imaging test is more effective in showing papillomas than a standard mammogram. However, a mammogram will also be performed to check for any other types of abnormalities.
Additional tests may be performed as well:
A breast biopsy can be performed to rule out cancer. In a breast biopsy, your doctor will insert a thin needle into your breast tissue and remove some cells. This type of biopsy is called a fine needle aspiration. Your doctor may want to perform a surgical biopsy if you’ve been experiencing nipple discharge. This will allow them to examine your breast tissue more thoroughly.
If you have nipple discharge, your doctor may want to do a microscopic examination of breast discharge to look for cancer cells.
A ductogram can also help your doctor make a diagnosis. This is a type of X-ray that helps determine the underlying cause of nipple discharge. During a ductogram, contrast dye is injected into your breast ducts so your doctor can view them in the X-rays more easily. Though this test may be used in some cases, it has largely been replaced by ultrasound.
Standard treatment for this condition involves surgery to remove the papilloma and the affected part of the milk duct. The surgery is typically done under general anesthesia, which means that you’ll be asleep during the procedure.
Depending on the severity of the condition, you may or may not need to stay in the hospital overnight. You’ll have a small wound from the incision, usually near your nipple. While it may initially leave a scar, the scar will fade over time.
The tissues removed during the surgery will be tested for the presence of cancerous cells. Further treatment may be necessary if cancerous cells are found.
The outlook for people with intraductal papilloma is usually good once the papilloma is surgically removed. If you have multiple papillomas and you’re under age 35, you should speak with your doctor about the increased risk for breast cancer.
Ask your doctor for information about support groups or counselors who can help you through the treatment process.
There’s no specific way to prevent intraductal papilloma. However, you can increase the likelihood of early detection by seeing your doctor regularly for breast exams, doing monthly breast self-exams, and having regular screening mammograms. You should also call your doctor if you have concerns about anything related to your breast health.
Written by: Jaime Herndon and Lauren Reed-Guy
Medically reviewed on: May 11, 2017: Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT
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