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Intraductal Papilloma

Intraductal Papilloma is a benign (non-cancerous) and small wart-like tumor that develops in the milk ducts of the breast. Its size is generally less than 1cm, but it can grow up to 5cm. Intraductal Papilloma usually develops close to the nipple, but it can also occur elsewhere on the breast.

This breast condition is known to occur mostly among women of ages 40 years and above and develops naturally as the breast changes with age. Although quite rare, men can also get this type of breast condition. Intraductal Papilloma may sound similar to papillary breast cancer, but they are quite different.

There are 3 types of Intraductal Papilloma:

  • Solitary intraductal papilloma: These are singular tumors that usually grows near the nipple, in one of the largest milk ducts.
  • Multiple intraductal papilloma: These tumors are quite small, and mostly develop in multiples at the same time. They grow in the small milk ducts, away from the nipple.
  • Papillomatosis: Within the small milk ducts, very small cell growths occur, which are not quite distinct.

Common Symptoms of Intraductal Papilloma

Some of the most common symptoms of Intraductal Papilloma include:

  • Breast lump or lumps
  • Nipple discharge
  • Pain or discomfort in the breast
  • Breast enlargement

Diagnosis of Intraductal Papilloma

Intraductal Papilloma can be found by chance either during a routine breast screening, if you have symptoms similar to those of the breast condition, or after a breast surgical procedure. Afterwards you’ll be referred to a breast specialist for further examination. Intraductal Papilloma is usually diagnosed through a range of tests which include:

  1. An ultrasound scan
  2. Mammogram
  3. Breast examination
  4. A core biopsy whereby a sample of the breast tissue is taken to be examined under a microscope.
  5. Fine Needle Aspiration (FNA): Here, a fine needle and syringe are used to take samples of the cells to be observed under a microscope.
  6. Vacuum Assisted Biopsy: Done under local anesthesia, a hollow needle is attached to a vacuum, which collects breast tissue via suction for more examination.

NOTE: The diagnosis method varies from case to case, as well as the age. For instance, women below 40 years are more likely to have an ultrasound compared to older women. This is because the breast tissue of younger women is denser, which can make the image during a mammogram less clear.

Treatment of Intraductal Papilloma

If the test results come back positive for an Intraductal Papilloma, the go-to treatment method is usually surgery.

1.     Excision Biopsy Surgery

An excision biopsy is a surgical procedure used to remove Intraductal Papilloma. This can be done under local or general anesthesia. After the removal of the breast tissue, they are taken to the laboratory for further examination under a microscope to confirm the diagnosis.

After the surgery to remove the Intraductal Papilloma, the surgeon mostly uses dissolvable sutures, which will not need to be removed afterwards. If non-dissolvable stitches are used, they’ll need to be removed after 7 – 10 days post-surgery. This procedure can leave a scar, which will fade over time.

2.     Vacuum assisted (VAC/VAB) excision biopsy

Vacuum assisted excision biopsy, which you might be offered, involves a process of removing the Intraductal Papilloma under local anesthesia, without having a full surgical procedure under general anesthesia.

During the procedure, a small cut is made on the skin on your breast whereby a probe, which is connected to a vacuum-like device is placed. The Intraductal Papilloma is then suctioned by the vacuum through the hollow probe into a collecting chamber. The surgeon is usually guided by an ultrasound while performing the procedure. If you opt for this procedure, then invasive surgery can be avoided.

Although vacuum assisted excision biopsy is considered minimally invasive, there might be bruising and some degree of discomfort after the procedure, which will last for a few days. This procedure might not affect the shape of the breast, but there might be a dent where the Intraductal Papilloma was.

Further Surgery

If it happens that after either one of the above surgeries have been performed to remove the Intraductal Papilloma and your nipple continues to have discharge, then further surgery might be required to either remove:

  • All the major breast ducts (total duct excision)
  • Only the affected ducts (microdochectomy)

After the surgery, which is done under local anesthesia, you may need to stay overnight at the hospital, although the procedure is considered a day case, which means you’re sent home the same day.

After a total duct excision, breast feeding from that breast might not be possible, but could be possible after a microdochectomy.

Do Intraductal Papilloma Increase the Risk of Breast Cancer?

Being diagnosed with an Intraductal Papilloma can make one feel uneasy thinking they are at a greater risk of developing breast cancer. Fortunately, Intraductal Papilloma do not increase the risks of developing breast cancer. On the other hand, if the Intraductal Papilloma contains abnormal non-cancerous cells, the chances of developing breast cancer in the future increase very slightly. But still, this is not a guarantee that you’ll develop breast cancer in the future. To stay breast aware, you should continue with the routine breast screening as usual, and if you are concerned about any changes that your breasts might have, it is recommended you visit your doctor at the earliest.

Next Steps

At King’s College Hospital London Dubai, our Breast Care Clinic caters to every type of breast cancer and breast conditions. If you are facing any kind of abnormal changes to your breast, regardless how small, get in touch for a consultation with one of our breast doctors. For more information on breast cancer and breast care, book an appointment below.

 

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