Intraductal Papilloma

What it is

Intraductal papilloma is a small, benign, wart-like growth that forms inside a breast duct, usually close to the nipple, in women between ages 35 and 55. The most common sign is spontaneous nipple discharge, clear or bloody, from a single side; sometimes there is a small palpable lump behind the areola. Diagnosis involves a clinical exam, ultrasound, mammography and, often, a biopsy; MRI and ductography help in selected cases. Since needle biopsy does not always rule out the presence of atypical cells, the usual approach is surgical removal of the papilloma and the affected duct, under anesthesia, with a discreet incision around the areola, and complete analysis of the material. Multiple papillomas require closer follow-up.

Most common symptoms

• Spontaneous nipple discharge, on one side only
• Clear, yellowish or bloody fluid that stains the bra
• A small palpable lump behind the areola or near the nipple
• Tenderness or mild discomfort around the nipple
• Increased fullness in the areola, in some cases
• No symptoms, found on an imaging exam

Causes and risk factors

• Benign growth of the cells lining the breast duct
• Age between 35 and 55, the range where it is most frequent
• Hormonal stimulation of the ducts, which favors proliferation
• Multiple papillomas, farther from the nipple and in younger women
• History of other proliferative benign breast lesions

How it is diagnosed

The investigation begins with the history of the discharge and a clinical exam, in which your breast specialist compresses the areola to identify the duct the fluid comes from and checks for a lump behind the nipple. Ultrasound, performed on site, usually shows the dilated duct with the lesion inside it; mammography is ordered depending on age. Ultrasound-guided biopsy confirms the diagnosis in most cases, and MRI or ductography helps when the imaging is not conclusive.

How we treat it at Femi Saúde

Because needle biopsy does not always rule out atypical cells inside the papilloma, the usual approach is surgical removal of the lesion and the affected duct, with complete analysis of the material. The breast health team at Femi Saúde plans the surgery with a discreet incision around the areola, under anesthesia, generally with same-day discharge and a gradual return to activities. In selected cases, when the biopsy is extensive and shows no atypia, follow-up with periodic exams may be an alternative, decided together with the patient. Multiple papillomas call for closer surveillance. The plan is individualized for each case.

What we offer